Critical role of hyperthermic intraperitoneal chemoperfusion in the treatment of a patient with <i>Pseudomyxoma peritonei</i>

Cole, Karin L.; Choudry, Haroon A.; Jones, Heather L.; Goodell, Pamela P.; Bartlett, David L.

doi:10.1002/jso.23088

Cited by 10 publications

(7 citation statements)

References 13 publications

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“…For patients with clinically indolent, low-grade disease, cytoreductive surgery with a goal of dramatically reducing or eliminating all tumor burden has been shown to substantially prolong survival. [15][16][17][18][19][20] Systemic chemotherapy is believed to be of little benefit for most patients with indolent peritoneal disease. 12,15,21 For patients with disseminated high-grade mucinous adenocarcinoma that is likely to pursue a more aggressive clinical course, the inherent risks of aggressive surgical debulking and cytoreduction must be carefully considered against the reduced likelihood of prolonged survival.…”

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confidence: 99%

Clinicopathologic and molecular analysis of disseminated appendiceal mucinous neoplasms: identification of factors predicting survival and proposed criteria for a three-tiered assessment of tumor grade

et al. 2014

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Previous studies have demonstrated that the prognosis of disseminated mucinous appendiceal neoplasms is highly dependent upon tumor grade. Reflecting this, the 7th edition of the American Joint Committee on Cancer (AJCC) staging system now incorporates a three-tier grading system for prognostic staging of mucinous appendiceal tumors. However, the grading criteria are not well described. In order to address this issue, we evaluated clinicopathologic and molecular features of 219 cases from 151 patients with widely disseminated appendiceal mucinous neoplasia treated at our institution between 2004 and 2012. We identified histologic features that were associated with worse overall survival on univariate analysis: destructive invasion, high cytologic grade, high tumor cellularity, angiolymphatic invasion, perineural invasion, and signet ring cell component (all with Po0.0001). We used these morphologic characteristics to classify neoplasms into three grades: AJCC grade G1 lacked all adverse histologic features; AJCC grade G2 had at least one adverse histologic feature (except a signet ring cell component); and AJCC grade G3 were defined by the presence of a signet ring cell component. Patients with AJCC grade G2 and grade G3 adenocarcinomas had a significantly worse prognosis compared with AJCC grade G1 (Po0.0001 for each). A trend toward worse overall survival was identified for patients with AJCC grade G3 adenocarcinomas compared with AJCC grade G2 adenocarcinomas (P ¼ 0.07). Our multivariate analysis found that this three-tier grading system was a significant predictor of outcome (P ¼ 0.008), independent of other prognostic variables. After controlling for other prognostic variables, AJCC grade G2 was associated with a 2.7-fold increased risk of death (95% confidence interval (CI), 1.2-6.2) and AJCC grade G3 was associated with a 5.1-fold increased risk of death (95% CI, 1.7-14) relative to grade G1 tumors. Our results indicate that evaluation of a limited set of adverse histologic features allows for the separation of disseminated mucinous neoplasms of appendiceal origin into three morphologically defined and prognostically relevant grades as advocated by the AJCC.

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confidence: 99%

Clinicopathologic and molecular analysis of disseminated appendiceal mucinous neoplasms: identification of factors predicting survival and proposed criteria for a three-tiered assessment of tumor grade

et al. 2014

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“…The use of cCRS + HIPEC (with mitomycin C) allows to obtain many long-term survival rates in the majority of patients (10-year survival approx. 60%-70%) [7][8][9]. Sugarbaker et al analyzed 385 patients diagnosed with PMP, treated with cCRS (CCR0/CCR1) and HIPEC.…”

Section: Resultsmentioning

confidence: 99%

Treatment of peritoneal surface neoplasms with intraperitoneal chemotherapy in hyperthermia

Mielko

Ciaseł

Skórzewska

et al. 2015

Polish Journal of Public Health

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Effective treatment of peritoneal surface neoplasms is possible through the simultaneous use of cytoreductive surgery with intraperitoneal chemotherapy in hyperthermia. It is successfully performed in patients with peritoneal pseudomyxoma, mesothelioma, as well as a limited and resectable peritoneal carcinomatosis in the course of colorectal cancer. It can also be used in patients with gastric or ovarian cancer but also metastatic colorectal cancer or metastases to the ovaries from gastric cancer. Aggressive surgical management of patients with primary or secondary neoplasms of the peritoneal surface was initiated by Sugarbaker's research group.

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“…Due to the rarity of this disease entity, there is no standardized approach to PSM arising from a primary breast cancer. Controversy exists over the management of PSM arising from other primary sources, although current approaches to gynecologic 43 and intestinal 44 , 45 PSM suggest that complete cytoreduction and heated intraperitoneal chemotherapy may provide a survival advantage. Evaluation of aggressive cytoreduction in patients with carcinomatosis of unknown primary suggests some benefit in terms of palliation and possibly survival 46 .…”

Section: Review Of the Literature And Discussionmentioning

confidence: 99%

Infiltrating Lobular Carcinoma of the Breast Presenting as Gastrointestinal Obstruction: A Mini Review

Carcoforo¹,

Raiji²,

Langan³

et al. 2012

J. Cancer

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One in twelve American women will develop breast cancer, with infiltrating lobular carcinoma (ILC) comprising approximately 15% of these cases. The incidence of ILC has been increasing over the last several decades. It has been hypothesized that this increase is associated with combined replacement hormonal therapy. Although pathologically distinct from infiltrating ductal carcinoma (IDC), ILC is treated in the same manner as IDC. However, ILC demonstrates significantly different patterns of late local recurrence and distant metastasis. The incidence of extra-hepatic gastrointestinal metastases is reported to be 6% to 18%, with stomach being most common. Herein, we present a brief review of the literature and a typical case involving ILC initially presenting as a small bowel obstruction. Evidence suggests that the late clinical patterns of ILC are distinctly separate from IDC and physicians need be cognizant of its late local recurrence and unique late metastatic pattern. Different follow up strategy should be entertained in patients with ILC.

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Critical role of hyperthermic intraperitoneal chemoperfusion in the treatment of a patient with Pseudomyxoma peritonei

Cited by 10 publications

References 13 publications

Clinicopathologic and molecular analysis of disseminated appendiceal mucinous neoplasms: identification of factors predicting survival and proposed criteria for a three-tiered assessment of tumor grade

Clinicopathologic and molecular analysis of disseminated appendiceal mucinous neoplasms: identification of factors predicting survival and proposed criteria for a three-tiered assessment of tumor grade

Treatment of peritoneal surface neoplasms with intraperitoneal chemotherapy in hyperthermia

Infiltrating Lobular Carcinoma of the Breast Presenting as Gastrointestinal Obstruction: A Mini Review

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