Appendiceal tumours and pseudomyxoma peritonei: Literature review with PSOGI/EURACAN clinical practice guidelines for diagnosis and treatment

Govaerts, Kim; Lurvink, Robin J.; Hingh, Ignace H. J. T. de; Speeten, Kurt Van der; Villeneuve, Laurent; Kusamura, Shigeki; Képénékian, Vahan; Deraco, Marcello; Gléhen, Olivier; Moran, Brendan; Barrios-Sánchez, Pedro; Baumgartner, Joel M.; Ben‐Yaacov, Almog; Bertulli, Rossella; Cashin, Peter; Cecil, Tom; Dayal, Sanjeev; Simone, Michele De; Foster, Jason M.; Goèré, Diane; Lehmann, Kuno; Li, Yan; Loggie, Brian W.; Mohamed, Faheez; Morris, David L.; Nissan, Aviram; Piso, Pompiliu; Pocard, Marc; Rau, Beate; Reymond, Marc A.; Sidéris, Lucas; Spiliotis, John; Sugarbaker, Paul H.; Verwaal, Victor J.; Wilson, Malcom S.; Yonemura, Yutaka; Yu, Yang

doi:10.1016/j.ejso.2020.02.012

Cited by 134 publications

(159 citation statements)

References 162 publications

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“…In the present study, the two-step approach resulted in a median PCI reduction of 12 (33 to 21) between the two procedures, with a combined median operative time of 900 minutes, estimated blood loss of 1900 mL and hospital stay of 35 days. However, severe complications were reported in only 25% of patients with no mortality, which is consistent with morbidity rates (2.7-33%) and mortality rates (0-2.7%) reported in the literature [26] for all PMP patients, regardless of the PCI. We could hypothesize that in a two-step approach, operative outcomes are cumulative, but morbidity and mortality are not, with each procedure having its own risks and associated complications.…”

Section: Discussionsupporting

confidence: 89%

“…Having said that, it is noteworthy that the patient was symptomatic (bloating and abdominal discomfort) before his rst surgery and felt much better after, without severe morbidity. In the recent guidelines published by PSOGI/EURACAN (European network for Rare Adults Solid Cancer) [26], tumor debulking was an accepted strategy for selected patients with unresectable low grade PMP, as it may improve quality of life with acceptable morbidity and mortality. Even though the patients undergoing the two-step approach are operated with a curative intent,…”

Section: Discussionmentioning

confidence: 99%

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Two-step cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for pseudomyxoma peritonei with high peritoneal carcinomatosis index

Trilling

Brind’Amour

Hamad

et al. 2020

Preprint

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Background Complete cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is the only curative treatment for pseudomyxoma peritonei (PMP) arising from the appendix. High peritoneal carcinomatosis index (PCI) is associated with an increased risk of surgical complications. The objective of this study was to present the results of a planned two-step surgical strategy to decrease postoperative morbidity and improve resectability of patients with very high PCI.Methods All patients who underwent a planned two-step surgical approach for PMP between January 2012 and March 2020 were included. Data was retrospectively reviewed and analyzed. The first surgery included a complete CRS of the inframesocolic compartment and omentectomy. HIPEC was delivered at the second surgery, after complete CRS of the supramesocolic compartment. Postoperative morbidity was assessed using the Clavien-Dindo classification and survival results were also collected. Results Eight patients underwent the two-step approach. Seven had a low-grade disease and one had a high-grade disease. The median PCI was 33 (29-39) and the median time between the two procedures was 111 days. One patient was deemed unresectable at the second surgery. The rate of major morbidity was 0% for the first step and 25% for the second step, with no mortality. Median follow-up was 53.8 months. Conclusion A two-step surgical management for low-grade PMP patients with very high PCI is safe and feasible, with acceptable postoperative morbidity and no compromise on oncological outcomes.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Two-step cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for pseudomyxoma peritonei with high peritoneal carcinomatosis index

Trilling

Brind’Amour

Hamad

et al. 2020

Preprint

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“…The recent international recommendations of the PSOGI and EURACAN for the treatment of pseudomyxoma peritonei (PMP), which integrate an exhaustive analysis of the literature and a Delphi process based on three rounds of voting by 80 international experts, give the cytoreduction-HIPEC combination as the gold standard treatment for this pathology [13]. This strategy gave overall survival rates of more than 60% at 10 years in the two main literature series, and a median disease-free survival time of 98 months in expert centers [14,15].…”

Section: Prioritization According To Prognosis and The Impact Of Diffmentioning

confidence: 99%

Treatment of primary and metastatic peritoneal tumors in the Covid-19 pandemic. Proposals for prioritization from the RENAPE and BIG-RENAPE groups

Gléhen

Képénékian

Bouché

et al. 2020

Journal of Visceral Surgery

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Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

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“…24 For this reason, most experts recommend prophylactic CRS + HIPEC at the time of the right hemicolectomy, especially if the primary was a T4, perforated or if the resection margins were positive. 25 Adjuvant chemotherapy needs to be assessed on an individual basis as there are no randomized data available for these rare tumours. Most centres adhere to colorectal cancer guidelines for adjuvant therapy and follow-up.…”

Section: Mucinous Appendiceal Adenocarcinomamentioning

confidence: 99%

Mucinous appendiceal neoplasms with or without pseudomyxoma peritonei: a review

Soucisse

Lansom

Alshahrani

et al. 2020

ANZ Journal of Surgery

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Mucinous appendiceal neoplasms (MANs) are rare tumours and the primary cause of pseudomyxoma peritonei. These tumours have a much more benign course than typical colorectal cancers, generally growing for many years before giving any clinical signs. The spectrum of presentations, tumour stages and the underlying cytology is very wide, warranting from the simplest operation like an appendicectomy to the most complicated operation like a complete cytoreduction surgery and hyperthermic intraperitoneal chemotherapy. Fortunately, most patients can be offered a curative treatment, but limiting operative morbidity without compromising oncologic outcomes is the biggest challenge in managing these patients. Histopathology is the cornerstone of decision making for MANs, but is also subject to ongoing debate because of a lack of terminology consensus amongst pathologists. Combined with the rarity of this disease, the multiple histopathologic classification updates of MANs explain the ongoing confusion amongst clinicians in regard to individual optimal treatment. This review will cover the most recent histological classification of MANs and attempt to clarify optimal management of patients with different clinical presentation and histologic combinations.

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Appendiceal tumours and pseudomyxoma peritonei: Literature review with PSOGI/EURACAN clinical practice guidelines for diagnosis and treatment

Cited by 134 publications

References 162 publications

Two-step cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for pseudomyxoma peritonei with high peritoneal carcinomatosis index

Two-step cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for pseudomyxoma peritonei with high peritoneal carcinomatosis index

Treatment of primary and metastatic peritoneal tumors in the Covid-19 pandemic. Proposals for prioritization from the RENAPE and BIG-RENAPE groups

Mucinous appendiceal neoplasms with or without pseudomyxoma peritonei: a review

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