Pseudomyxoma peritonei: A French multicentric study of 301 patients treated with cytoreductive surgery and intraperitoneal chemotherapy

Élias, Dominique; Gilly, François Noël; Quénet, François; Béréder, Jean-Marc; Sidéris, Lucas; Mansvelt, B.; Lorimier, G.; Gléhen, Olivier

doi:10.1016/j.ejso.2010.01.006

Cited by 219 publications

(161 citation statements)

References 24 publications

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“…In particular, long-term survival is noted to be better in some studies. [85][86][87] Several factors have been associated with success in the management of PMP. One of the most important factors is attaining complete cytoreduction, which is achieved in 40-91% of cases.…”

Section: Treatmentmentioning

confidence: 99%

“…87 In this regard, the experience of the surgeon may have a role, with specialized centers achieving better survival statistics. 85,86 Extensive involvement of the small bowel or mesentery predicts a high likelihood of incomplete cytoreduction. As previously discussed, peritoneal tumor grade is another factor that affects outcome.…”

Section: Treatmentmentioning

confidence: 99%

“…As previously discussed, peritoneal tumor grade is another factor that affects outcome. 85,86 Figure 15 Signet ring cells in peritoneal mucinous neoplasia. Recent data suggest that the presence of signet ring cells in any amount may be a poor prognostic indicator in pseudomyxoma peritonei, and their presence qualifies the tumor as high grade in a two-tiered system or as pseudomyxoma peritonei-3 in a threetiered system.…”

Section: Treatmentmentioning

confidence: 99%

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Mucinous epithelial neoplasms of the appendix and pseudomyxoma peritonei

2015

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Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

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Mucinous epithelial neoplasms of the appendix and pseudomyxoma peritonei

2015

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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.…”

mentioning

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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“…Во французском многоцентровом исследовании, в ко-тором принимал участие 301 пациент с псевдомик-сомой брюшины, 5-летняя выживаемость после ле-чения по указанной схеме составила 73%, медиана продолжительности жизни -более 100 мес [9]. В крупном многоцентровом регистре, включающем 2298 пациентов с псевдомиксомой брюшины, со-держатся данные о медиане продолжительности жизни 196 месяцев, а 59% всех пациентов по итогам комбинированного лечения живут больше 15 лет [6].…”

Section: Discussionunclassified