Early- and long-term outcome data of patients with pseudomyxoma peritonei from appendiceal origin treated by a strategy of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.
Citation: Journal of Clinical Oncology. 30(20):2449-56, 2012 Jul 10.PMID: 22614976Institution: MedStar Washington Hospital Center | Washington Cancer InstituteDepartment: Surgery/General SurgeryForm of publication: Journal ArticleMedline article type(s): Journal Article | Multicenter Study | Research Support, Non-U.S. Gov'tSubject headings: *Antineoplastic Combined Chemotherapy Protocols/tu [Therapeutic Use] | *Appendiceal Neoplasms/pa [Pathology] | *Hyperthermia, Induced/mt [Methods] | *Peritoneal Neoplasms/sc [Secondary] | *Peritoneal Neoplasms/th [Therapy] | *Pseudomyxoma Peritonei/dt [Drug Therapy] | *Pseudomyxoma Peritonei/su [Surgery] | Adolescent | Adult | Aged | Aged, 80 and over | Combined Modality Therapy | Disease-Free Survival | Female | Humans | Injections, Intraperitoneal | Male | Middle Aged | Peritoneal Neoplasms/dt [Drug Therapy] | Peritoneal Neoplasms/mo [Mortality] | Peritoneal Neoplasms/su [Surgery] | Pseudomyxoma Peritonei/mo [Mortality] | Survival Rate | Young AdultYear: 2012Local holdings: Available online from MWHC library: 1999 - present, Available in print through MWHC library: 1999 - 2008ISSN:- 0732-183X
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 22614976 | Available | 22614976 |
Available online from MWHC library: 1999 - present, Available in print through MWHC library: 1999 - 2008
CONCLUSION: The combined modality strategy for PMP may be performed safely with acceptable morbidity and mortality in a specialized unit setting with 63% of patients surviving beyond 10 years. Minimizing nondefinitive operative and systemic chemotherapy treatments before definitive cytoreduction may facilitate the feasibility and improve the outcome of this therapy to achieve long-term survival. Optimal cytoreduction achieves the best outcomes.
PATIENTS AND METHODS: A retrospective multi-institutional registry was established through collaborative efforts of participating units affiliated with the Peritoneal Surface Oncology Group International.
PURPOSE: Pseudomyxoma peritonei (PMP) originating from an appendiceal mucinous neoplasm remains a biologically heterogeneous disease. The purpose of our study was to evaluate outcome and long-term survival after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) consolidated through an international registry study.
RESULTS: Two thousand two hundred ninety-eight patients from 16 specialized units underwent CRS for PMP. Treatment-related mortality was 2% and major operative complications occurred in 24% of patients. The median survival rate was 196 months (16.3 years) and the median progression-free survival rate was 98 months (8.2 years), with 10- and 15-year survival rates of 63% and 59%, respectively. Multivariate analysis identified prior chemotherapy treatment (P < .001), peritoneal mucinous carcinomatosis (PMCA) histopathologic subtype (P < .001), major postoperative complications (P = .008), high peritoneal cancer index (P = .013), debulking surgery (completeness of cytoreduction [CCR], 2 or 3; P < .001), and not using HIPEC (P = .030) as independent predictors for a poorer progression-free survival. Older age (P = .006), major postoperative complications (P < .001), debulking surgery (CCR 2 or 3; P < .001), prior chemotherapy treatment (P = .001), and PMCA histopathologic subtype (P < .001) were independent predictors of a poorer overall survival.
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