Outcomes in Peritoneal Dissemination from Signet Ring Cell Carcinoma of the Appendix Treated with Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

Muñoz‐Zuluaga, Carlos; Sardi, Armando; King, Mary Caitlin; Nieroda, Carol; Sittig, Michelle; MacDonald, Ryan; Gushchin, Vadim

doi:10.1245/s10434-018-7007-3

Cited by 28 publications

(32 citation statements)

References 43 publications

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“…Timeline of a CRS/HIPEC center development. CC, completeness of cytoreduction; CRS, cytoreductive surgery; dх laps, diagnostic laparoscopies; gyn, gynecology; HIPEC, hyperthermic intraperitoneal chemotherapy; NP, nurse practitioner; PA, physician assistant; S#1, surgeon #1; S#2, surgeon #2; S#3, surgeon #3; 22‐28 # , major publications (please see corresponding number in the references) [Color figure can be viewed at wileyonlinelibrary.com]…”

Section: Methodsmentioning

confidence: 99%

Surgical and oncological outcomes after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy at a nonacademic center: 25‐year experience

Nikiforchin

Gushchin

King

et al. 2021

Journal of Surgical Oncology

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Background Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) is predominantly performed and studied in academic centers. While developing CRS/HIPEC programs in nonacademic hospitals can increase accessibility, its safety and oncological efficacy remains unclear. We evaluated CRS/HIPEC outcomes in a nonacademic setting. Methods A single‐center descriptive study was conducted using a prospective database. Data of all CRS/HIPEC attempts in peritoneal surface malignancies (PSM) patients from October 1994 to November 2019 were extracted. Surgical and survival outcomes were measured. Center experience was assessed by quartiles of cases. Results Overall, 856 patients underwent 948 CRS/HIPEC attempts: 788 (83%) completed CRS/HIPECs, 144 (15%) aborted HIPECs, and 16 (2%) complete cytoreductions (CC‐0/1) without chemoperfusion. For completed CRS/HIPECs, median peritoneal cancer index was 24 (interquartile range: 10–33) and CC‐0/1 rate was 88%. Major complications occurred in 23.5% with 30‐ and 100‐day mortality of 1.0% and 2.3%, respectively. Median overall survival was 68 months (95% confidence interval [CI]: 50–86). Median progression‐free survival was 37 months (95%CI: 28–46). Incomplete cytoreduction and major complication rates decreased over time, while mortality remained low and constant. Conclusions CRS/HIPEC at a nonacademic center with advanced surgical and auxiliary services is a safe option to treat PSM with favorable surgical and oncological outcomes.

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Section: Methodsmentioning

confidence: 99%

Surgical and oncological outcomes after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy at a nonacademic center: 25‐year experience

Nikiforchin

Gushchin

King

et al. 2021

Journal of Surgical Oncology

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“…Well-established predictors of long-term survival following CRS/HIPEC include tumor burden measured by peritoneal cancer index (PCI), optimal cytoreduction, and absence/low percentage of goblet or signet ring cell histology. [8][9][10][11] While these prognostic tools are useful, they have limited utility before CRS/HIPEC since they are most accurately determined intraoperatively or postoperatively. Currently, there is a need for reliable preoperative tools in APM that can predict the benefit of surgical management before CRS/HIPEC surgical intervention.…”

Section: Introductionmentioning

confidence: 99%

Exploring the prognostic and therapeutic utility of expanded mutation profiling in appendix peritoneal metastasis managed with CRS/HIPEC

Zhang

Plambeck

Craig

et al. 2021

Journal of Surgical Oncology

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Introduction: Interrogation of cancers with next-generation sequencing (NGS) mutation panels has become widely utilized, identifying prognostic and actionable mutations. This study explored the value of expanded mutation analysis in appendix peritoneal metastases (APM). Methods: Forty-eight APM patients treated 2013-2018 were retrospectively collected from a registry. Fifty-gene NGS analysis was performed in CLIA approved lab to obtain mutation profiles. All patients underwent cytoreductive surgery (CRS)/hyperthermic intraperitoneal chemotherapy (HIPEC) with mitomycin C. Peritoneal cancer index (PCI), optimal CRS, survival (overall survival [OS] and progression-free survival [PFS]) data were collected. Survival analyses were performed on all APM, high-grade (HG), and low grade (LG) subsets, evaluating the impact of specific mutations on the outcome.Results: Eighty-three percent of APM had a mutation identified. KRAS was most frequent, 65% (88% LG 42% HG) with GNAS identified in 92% of LG-APM. SMAD4 and/or TP53 mutations occurred in 25% of APM with observed decreased OS (46 vs. 81 months p = .0029); worse in HG-APM (26 vs. 49 months p = .0451).SMAD4 was associated with the most significant reduction in PFS in APM (p = .0085). Actionable mutations were identified in 73% of APM patients.Conclusions: Most frequent mutations were KRAS, TP53, and SMAD4, and actionable mutation detection was common. SMAD4 and TP53 were associated with decreased OS. NGS mutation profiling has potential utility in APM.

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“…The study showed that CRS/HIPEC can achieve a five-year survival of 25% for a patient with PMCA-S, which may improve to 51% with negative lymph nodes. The study endorsed the treatment method [13]. On the other hand, in another retrospective study conducted at the Washington Cancer Institute that included 494 patients with PMCA, of whom 80 had PMCA-S, the five-year overall survival for the latter group was 22% and the median survival time was 18.9 months.…”

Section: Discussionmentioning

confidence: 95%

Clinicopathologic Features and Survival Outcomes of Signet Ring Cell Carcinoma of the Appendix: An Analysis of the Surveillance, Epidemiology, and End Results Database

Abushalha¹,

Tuqan²,

Albagoush³

et al. 2020

Cureus

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Background and objective Signet ring cell carcinoma of the appendix (SRCCA) is an exceedingly rare tumor, and very limited data are available regarding its characteristics and survival probabilities. Our objective in this study was to utilize the Surveillance, Epidemiology, and End Results (SEER) database to explore the patient and tumor characteristics and to characterize the three-and five-year cancer-specific survival (CSS) probabilities of SRCCA. Methods Patients with SRCCA diagnosed between 2000 and 2015 were analyzed using the SEER database. The three-and five-year CSS probabilities were estimated by the Kaplan-Meier method, and the groups were compared using log-rank comparisons and multivariable Cox hazard regression analysis.

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Outcomes in Peritoneal Dissemination from Signet Ring Cell Carcinoma of the Appendix Treated with Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

Cited by 28 publications

References 43 publications

Surgical and oncological outcomes after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy at a nonacademic center: 25‐year experience

Surgical and oncological outcomes after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy at a nonacademic center: 25‐year experience

Exploring the prognostic and therapeutic utility of expanded mutation profiling in appendix peritoneal metastasis managed with CRS/HIPEC

Clinicopathologic Features and Survival Outcomes of Signet Ring Cell Carcinoma of the Appendix: An Analysis of the Surveillance, Epidemiology, and End Results Database

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