Treatment of advanced pseudomyxoma peritonei using cytoreductive surgery including total gastrectomy and perioperative chemotherapy.

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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
Name of journal: Journal of surgical oncologyAbstract: 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.All authors: Chang D, Sugarbaker PHOriginally published: Journal of Surgical Oncology. 2021 Apr 29Fiscal year: FY2022Fiscal year of original publication: FY2021Digital Object Identifier: ORCID: Date added to catalog: 2021-06-07
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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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