Treatment of advanced pseudomyxoma peritonei using cytoreductive surgery including total gastrectomy and perioperative chemotherapy.
Citation: Journal of Surgical Oncology. 124(3):378-389, 2021 Sep.PMID: 33914912Institution: Washington Cancer InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Adenocarcinoma, Mucinous/dt [Drug Therapy] | *Adenocarcinoma, Mucinous/su [Surgery] | *Appendiceal Neoplasms/dt [Drug Therapy] | *Appendiceal Neoplasms/su [Surgery] | *Pseudomyxoma Peritonei/dt [Drug Therapy] | *Pseudomyxoma Peritonei/su [Surgery] | Adenocarcinoma, Mucinous/pa [Pathology] | Adult | Aged | Appendiceal Neoplasms/pa [Pathology] | Cytoreduction Surgical Procedures/mt [Methods] | Female | Gastrectomy/mt [Methods] | Humans | Jejunostomy | Male | Middle Aged | Perioperative Care/mt [Methods] | Pseudomyxoma Peritonei/pa [Pathology] | Retrospective Studies | Survival RateYear: 2021ISSN:- 0022-4790
- Sugarbaker, Paul H:
- http://orcid.org/0000-0002-2431-7366
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 33914912 | Available | 33914912 |
BACKGROUND: Pseudomyxoma peritonei is a disease caused by the widespread distribution of mucinous tumor into the peritoneal space from a perforated appendiceal neoplasm.
CONCLUSIONS: A 10-year survival after cytoreductive surgery, total gastrectomy with temporary high diverting jejunostomy, and perioperative chemotherapy occurred in 58% of these patients with advanced pseudomyxoma peritonei. High-grade disease and extensive prior surgery with a high PSS were associated with reduced benefit. Copyright (c) 2021 Wiley Periodicals LLC.
METHODS: All patients in this study had cytoreductive surgery with total gastrectomy plus perioperative intraperitoneal chemotherapy. A high diverting jejunostomy was used on all patients. Patient characteristics, adverse events, and survival were accumulated prospectively.
RESULTS: Fifty-eight patients were available for long-term follow-up. In the univariate analysis, features associated with a less favorable outcome included female gender (p = 0.0127), intestinal obstruction before treatment (p = 0.00791), and prior surgical score (PSS) (p = 0.0054). In the multivariate analysis, the two significant variables were grade (p = 0.0458) and PSS (p = 0.0041). Median survival was 12 years with a 5-, 10-, and 20-year survival of 76%, 58%, and 37%, respectively. There were two postoperative deaths (3.4%) and Grades 3 and 4 adverse events in 20 (34.5%) patients.
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