Efficacy of modified FOLFOX6 chemotherapy for patients with unresectable pseudomyxoma peritonei

Hiraide, Sakura; Komine, Keigo; Sato, Yuko; Ouchi, Kota; Imai, Hiroo; Saijo, Ken; Takahashi, Masahiro; Takahashi, Shin; Shirota, Hidekazu; Takahashi, Masanobu; Ishioka, Chikashi

doi:10.1007/s10147-019-01592-x

Cited by 20 publications

(20 citation statements)

References 24 publications

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“…Furthermore, extensive disease [ 23 , 24 ], prolonged operative time, and postoperative complications are all factors associated with long-term impairment of quality of life [ 10 ], which has to be considered when performing CRS and HIPEC for such patients. Since the only therapeutic alternatives are debulking and systemic chemotherapy, which are both palliative options [ 25 ], CRS and HIPEC in this population may be considered in a curative intent, but only if a complete CRS is achievable with acceptable postoperative morbidity and impact on quality of life.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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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 consecutive patients who underwent a planned two-step surgical approach for PMP between January 2012 and March 2020 were retrospectively included. This approach was offered for patients with low-grade PMP with PCI > 28 for which feasibility of a complete CRS in one operation was uncertain. 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. The median PCI was 33 (29–39) and the median time between the two procedures was 111 days (90–212 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 (3–73 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: Discussionmentioning

confidence: 99%

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

et al. 2021

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“…Furthermore, extensive disease [23,24], prolonged operative time and postoperative complications are all factors associated with long-term impairment of quality of life [10], which has to be considered when performing CRS and HIPEC for such patients. Since the only therapeutic alternatives are debulking and systemic chemotherapy, which are both palliative options [25], CRS and HIPEC in this population may be considered in a curative intent, but only if a complete CRS is achievable with acceptable postoperative morbidity and impact on quality of life.…”

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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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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“…Moreover, tumor response is difficult to evaluate with standard radiological criteria, as PMP masses are mostly composed of mucin and it is unlikely to obtain a significant shrinkage even in case of full activity on tumoral cells. The results of SC showed a response rate ranging between 8-20%, median OS between 26-56 months, and 1-year OS rate of 84-91 [40][41][42][43][44] (Table 3). Although the recent introduction of immunotherapy has shown promising results in colorectal cancer (CRC) patients, especially those with defective DNA mismatch repair system (dMMR) [45], this treatment has not yet been tested in PMP patients.…”

Section: Palliative Systemic Chemotherapymentioning

confidence: 99%

Section: Systemic Treatmentsmentioning

confidence: 99%

Novel Perspectives in Pseudomyxoma Peritonei Treatment

Sommariva

Tonello

Rigotto

et al. 2021

Cancers

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Pseudomyxoma Peritonei (PMP) is an anatomo-clinical condition characterized by the implantation of neoplastic cells on peritoneal surfaces with the production of a large amount of mucin. The rarity of the disease precludes the evaluation of treatment strategies within randomized controlled trials. Cytoreductive Surgery (CRS) combined with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) has proven to be the only therapeutic option with potential chances of cure and long-term disease control. The present review discusses the epidemiology, pathogenesis, clinical presentation and treatment of PMP, focusing on the molecular factors involved in tumor progression and mucin production that could be used, in the upcoming future, to improve patient selection for surgery and to expand the therapeutic armamentarium.

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Efficacy of modified FOLFOX6 chemotherapy for patients with unresectable pseudomyxoma peritonei

Cited by 20 publications

References 24 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

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

Novel Perspectives in Pseudomyxoma Peritonei Treatment

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