Impact of Macroscopic Tumour Consistency and EPIC in Low-grade Appendiceal Neoplasms With Pseudomyxoma Peritonei

Cheng, Ernest; Shamavonian, Raphael; Mui, Jasmine; Karpes, Josh; Chen, Kerry; Ahmadi, Nima; Morris, David L.

doi:10.21873/anticanres.15855

Cited by 2 publications

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“…The median survival of patients undergoing CRS/HIPEC remains variable, ranging from 30 to 248 months depending on the primary histopathology [ 4 ], [ 5 ], [ 6 ], [ 7 ]. The addition of additional methods of delivering chemotherapy such as early postoperative intraperitoneal chemotherapy (EPIC) as further improved patient survival outcomes [ 8 ], [ 9 ], [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Overall survival and morbidity are not associated with advanced age for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: a single centre experience

Cheng

Shamavonian

Mui

et al. 2023

Pleura and Peritoneum

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Objectives Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) has enabled better prognosis for patients with peritoneal surface malignancies. However, in older age groups, short -and long-term outcomes are still perceived as poor. We evaluated patients aged 70 and over and determine if age is a predictor of morbidity, mortality and overall survival (OS). Methods A retrospective cohort analysis was performed on CRS/HIPEC patients and categorised by age. The primary outcome was overall survival. Secondary outcomes included morbidity, mortality, hospital and incentive care unit (ICU) stay and early postoperative intraperitoneal chemotherapy (EPIC). Results A total of 1,129 patients were identified with 134 aged 70+ and 935 under 70. There was no difference in OS (p=0.175) or major morbidity (p=0.051). Advanced age was associated with higher mortality (4.48 vs. 1.11 %, p=0.010), longer ICU stay (p<0.001) and longer hospitalisation (p<0.001). The older group was less likely to achieve complete cytoreduction (61.2 vs. 73 %, p=0.004) and receive EPIC (23.9 vs. 32.7 %, p=0.040). Conclusions In patients undergoing CRS/HIPEC, age of 70 and above does not impact OS or major morbidity but is associated with increased mortality. Age alone should not be a limiting factor in selecting CRS/HIPEC patients. Careful multi-disciplinary approach is needed when considering those of advanced age.

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Section: Introductionmentioning

confidence: 99%

Overall survival and morbidity are not associated with advanced age for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: a single centre experience

Cheng

Shamavonian

Mui

et al. 2023

Pleura and Peritoneum

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“…Compared to acellular mucin, cellular mucin is associated with higher risk for recurrence or progression; the cytological grade of extraappendiceal epithelium is an important prognostic indicator (1). Heated intra-peritoneal chemotherapy and early postoperative intra-peritoneal chemotherapy have improved the survival of patients with pseudomyxoma peritonei (2,3).…”

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confidence: 99%

Confined Low Grade Appendiceal Mucinous Neoplasm With Coexisting Distant Metastasis

ARSHI,

PETER,

LIANG

et al. 2023

In Vivo

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Background/Aim: Appendiceal mucinous neoplasms (AMNs) are tumors with dysplastic mucinous epithelium, a pushing growth pattern but no infiltrative invasion to the appendiceal wall. Some AMNs are associated with pseudomyxoma peritonei, characterized by intraperitoneal mucinous involvement. Recent studies have demonstrated that LAMNs confined to the appendix have low or no risk for disease recurrence, progression, and peritoneal involvement during follow up. Case Report: Here, we present two extremely rare cases with confined low grade appendiceal mucinous neoplasm (pTis and pT3) and simultaneous extraperitoneal subcutaneous or ovary involvement at the time of diagnosis. Conclusion: Our cases demonstrate that although the primary tumor is limited to the appendix, coexisting distant metastasis may occur on very rare occasions. Case ReportCase 1. A 48-year-old female had a medical history of gastroesophageal reflux disease (GERD) and migraines. She also had a history of adjustable gastric banding surgery 10 years ago, with a reservoir placed beneath the skin of the upper abdominal wall. This was subsequently removed 5 years ago. The patient presented to the surgery office with a bulging abdominal wall and pain at a previous surgical site, suspicious for incisional hernia. She was planned for a minimally invasive exploration and hernia repair.Prior to the operation, an abdominal and pelvic CT scan was performed. The CT study showed a 4 cm loculated fluid collection in the subcutaneous fat of the anterior abdominal wall. Radiological differentials include subcutaneous sebaceous 295

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Impact of Macroscopic Tumour Consistency and EPIC in Low-grade Appendiceal Neoplasms With Pseudomyxoma Peritonei

Cited by 2 publications

References 0 publications

Overall survival and morbidity are not associated with advanced age for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: a single centre experience

Overall survival and morbidity are not associated with advanced age for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: a single centre experience

Confined Low Grade Appendiceal Mucinous Neoplasm With Coexisting Distant Metastasis

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