Normal view MARC view ISBD view

Incomplete cytoreduction with peritoneal metastases from appendiceal mucinous neoplasms.

MedStar author(s):

Citation: Journal of Surgical Oncology. 126(8):1462-1470, 2022 Dec.PMID: 36102369Institution: Washington Cancer InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Adenocarcinoma, Mucinous | *Appendiceal Neoplasms | *Hyperthermia, Induced | *Peritoneal Neoplasms | Adenocarcinoma, Mucinous/su [Surgery] | Antineoplastic Combined Chemotherapy Protocols/tu [Therapeutic Use] | Appendiceal Neoplasms/pa [Pathology] | Appendiceal Neoplasms/su [Surgery] | Ascites/et [Etiology] | Combined Modality Therapy | Cytoreduction Surgical Procedures/ae [Adverse Effects] | Humans | Hyperthermia, Induced/ae [Adverse Effects] | Peritoneal Neoplasms/su [Surgery] | Prospective Studies | Retrospective Studies | Survival RateYear: 2022 ISSN:

0022-4790

Name of journal: Journal of surgical oncologyAbstract: BACKGROUND: Complete cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy is the standard of care for mucinous appendiceal neoplasms with peritoneal metastases. Despite many publications regarding selection factors favoring a complete CRS, incomplete CRS does occur. Patients with an incomplete CRS are the focus of this manuscript.CONCLUSIONS: When a surgeon is confronted by a procedure that will inevitably end with an incomplete CRS, a current trend is to close quickly and always avoid complications. Patients with low-grade neoplasms who present in the absence of tense ascites or bowel obstruction may gain years of survival by surgical reduction of tumor burden. Copyright © 2022 Wiley Periodicals LLC.METHODS: A retrospective analysis of prospective, histologic, and perioperative data was performed. Overall survival was the endpoint for the numerous assessments. Judgments regarding when to and when not to proceed with an incomplete CRS were sought.RESULTS: From a database of 949 patients who underwent an index CRS for appendiceal mucinous neoplasm, 264 patients (27.8%) had an incomplete CRS. The median overall survival was 1.8 years. Low-grade histopathology and absence of tense ascites or bowel obstruction were significantly associated with increased overall survival. More extensive surgery suggested a more favorable outcome.All authors: Chang D, Sugarbaker PHFiscal year: FY2023 Digital Object Identifier:

https://dx.doi.org/10.1002/jso.27087

ORCID:

http://orcid.org/0000-0002-2431-7366

Date added to catalog: 2022-12-13

Holdings ( 1 )
Title notes ( 5 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	36102369	Available		36102369

BACKGROUND: Complete cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy is the standard of care for mucinous appendiceal neoplasms with peritoneal metastases. Despite many publications regarding selection factors favoring a complete CRS, incomplete CRS does occur. Patients with an incomplete CRS are the focus of this manuscript.

CONCLUSIONS: When a surgeon is confronted by a procedure that will inevitably end with an incomplete CRS, a current trend is to close quickly and always avoid complications. Patients with low-grade neoplasms who present in the absence of tense ascites or bowel obstruction may gain years of survival by surgical reduction of tumor burden. Copyright © 2022 Wiley Periodicals LLC.

METHODS: A retrospective analysis of prospective, histologic, and perioperative data was performed. Overall survival was the endpoint for the numerous assessments. Judgments regarding when to and when not to proceed with an incomplete CRS were sought.

RESULTS: From a database of 949 patients who underwent an index CRS for appendiceal mucinous neoplasm, 264 patients (27.8%) had an incomplete CRS. The median overall survival was 1.8 years. Low-grade histopathology and absence of tense ascites or bowel obstruction were significantly associated with increased overall survival. More extensive surgery suggested a more favorable outcome.

English