Operability and early outcome in 100 consecutive laparotomies for peritoneal malignancy

Moran, Brendan; Mukherjee, Ankur; Sexton, Rosemary

doi:10.1002/bjs.5210

Cited by 62 publications

(30 citation statements)

References 27 publications

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“…In other published series recurrence or progression rates of 40-70% have been reported. 6,7,15 As in other series, we observed that pathological subtype and result of initial cytoreduction were the dominant factors related to progression. 3,10,17 The diagnosis of progressive disease is not always easy.…”

Section: Discussionsupporting

confidence: 79%

“…A number of series using this approach has now been published, showing indeed that longterm disease free and progression free survival can be improved. [3][4][5][6]15,16 Still, even after this combined modality treatment progression was observed in our series in 41% of cases. In other published series recurrence or progression rates of 40-70% have been reported.…”

Section: Discussionsupporting

confidence: 41%

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Progression of Pseudomyxoma Peritonei after Combined Modality Treatment: Management and Outcome

et al. 2006

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Background: Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is a treatment strategy for pseudomyxoma peritonei (PMP) with curative intent. The aim of this study was to determine the patterns of failure in patients who underwent such a procedure and to evaluate management and outcome of progressive disease.Methods: After exclusion of patients with overt malignancy, progression was studied in 96 PMP patients treated primarily by CRS with HIPEC. Location, pathology, management and outcome were recorded.Results: Median follow-up was 51.5 months (0.1-99.5). Median progression free survival (PFS) was 28.2 months (95% CI 18.3->). Progressive disease was mainly located sub hepatic (38%) or in multiple regions (36%). Pathological dedifferentiation was observed in 8 patients (20%). The choice of treatment depended on pathology, extent of disease and PFS. Seventeen patients were treated for progression by second CRS with (n=8) or without HIPEC (n=10). The 3-years overall survival (OS) probability after this treatment was 100% and 53.3% (95% CI 28.2-100%), respectively. Fifteen patients with (slow) progression were observed. Threeyears OS probability of these patients was 66.0% (95% CI 43.4-100%). All patients treated for progression by systemic chemotherapy only (n=6) had died of disease after a median follow up of 14.8 (9.8-33.6) months. A longer PFS after primary treatment was associated with longer OS after progression (P = 0.04).Conclusions: Progressive PMP after primary CRS with HIPEC is probably the result of technical failure and/or tumor biology. Management of progressive PMP can be valuable for selected patients and should depend primarily on the PFS.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionsupporting

confidence: 41%

Progression of Pseudomyxoma Peritonei after Combined Modality Treatment: Management and Outcome

et al. 2006

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“…We have reported our experience with similar results and projected 5 and 10 year disease free survival rates of 70 -80% in favourable cases of PMP [7].…”

Section: Introductionsupporting

confidence: 60%

“…The techniques have been previously described [7]. In total 29 patients received intra-operative, intraperitoneal, Mitomycin C (10mg/m2) for 1 hour at 42C.…”

Section: Surgery and Hipecmentioning

confidence: 99%

Prospective longitudinal study of quality of life following cytoreductive surgery and intraperitoneal chemotherapy for pseudomyxoma peritonei

Alves

Mohamed

Yadegarfar

et al. 2010

European Journal of Surgical Oncology (EJSO)

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This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…Peritonectomy and multivisceral resections were performed depending on the distribution pattern of peritoneal neoplasia and included hemi-/pancolectomy, omentectomy (omentum majus/minus), splenectomy, cholecystectomy, resection of the visceral surface of the liver, gastrectomy, rectal resection, partial or total peritonectomy, hysterectomy and/or adnectomy, as described previously [24] (table 2). HIPEC was scheduled for the 5th postoperative day by using the closed technique.…”

Section: Methodsmentioning

confidence: 99%

Feasibility of Delayed Hyperthermic Intraperitoneal Chemotherapy in Case of Unforeseen Complications

Mohr¹,

Hirche²,

Liebeskind³

et al. 2011

Eur Surg Res

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Background: Cytoreductive surgery (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC) can improve the prognosis of selected patients with peritoneal surface malignancy (PSM). Usually, treatment is performed as an extensive one-step approach. We investigated the feasibility of delayed HIPEC, if the one-step procedure was interrupted precociously. Methods: 42 patients with PSM who underwent CRS and delayed HIPEC from 2006–2008 were studied. HIPEC was performed 5 days after treatment with mitomycin, cisplatin and hyperthermia. Perioperative complications and toxicity were analyzed. Results: Delayed HIPEC was successfully completed in 40 of the 42 patients. In 2 cases, HIPEC was omitted because of complications during chemotherapy (anastomotic leakage and retroperitoneal edema). Minor and major surgical complications occurred in 18 and 9 of the 40 patients treated with HIPEC (45 vs. 22.5%), respectively. Toxicity grade II–IV (WHO criteria) was observed in 4 of them (10%). Median stay in the intensive care unit was 9 days (range 2–31) while the mean hospitalization time was 24 days (range 14–59). In this series, there was no mortality. Conclusion: Postponement of HIPEC after CRS (two-step approach) is feasible. Analysis of morbidity and mortality showed no significant difference to the one-step approach reported in the literature and no disadvantages for the patient. The two-step approach is an alternative option for patients who had to discontinue the one-step approach due to unpredictable intraoperative complications.

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Operability and early outcome in 100 consecutive laparotomies for peritoneal malignancy

Abstract: Cytoreduction combined with intraperitoneal chemotherapy is an emerging technique with promising results in selected patients with peritoneal malignancy.

Cited by 62 publications

References 27 publications

Progression of Pseudomyxoma Peritonei after Combined Modality Treatment: Management and Outcome

Progression of Pseudomyxoma Peritonei after Combined Modality Treatment: Management and Outcome

Prospective longitudinal study of quality of life following cytoreductive surgery and intraperitoneal chemotherapy for pseudomyxoma peritonei

Feasibility of Delayed Hyperthermic Intraperitoneal Chemotherapy in Case of Unforeseen Complications

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