Systemic metastases from low-grade and high-grade pseudomyxoma peritonei: Treatments and outcomes

Baratti, Dario; Milito, Pamela; Kusamura, Shigeki; Román, Lorena Martín; Guagliò, Marcello; Deraco, Marcello

doi:10.1016/j.ejso.2022.01.010

Cited by 7 publications

(4 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The CRS was performed as previously described [ 3 , 33 ]. Exploration of the peritoneal cavity allowed the quantification of peritoneal disease according to the PCI [ 8 ]. Then, a combination of peritonectomies and visceral resections was performed to achieve the minimal amount of residual disease.…”

Section: Methodsmentioning

confidence: 99%

“…Then, a combination of peritonectomies and visceral resections was performed to achieve the minimal amount of residual disease. This result was graded according to the CC-score as follows: CC-0 when no residual lesions were visible, CC-1 if tumours of less than 2.5 mm remained, and CC-2 and 3 for residual disease of more than 2.5 mm and 2.5 cm, respectively [ 8 ]. In selected patients, CRS was followed by HIPEC, performed with the closed-abdomen technique with a combination of cisplatin and mitomycin C at 42 °C for 90 min.…”

Section: Methodsmentioning

confidence: 99%

“…The comprehensive treatment combining a cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC), developed initially by Sugarbaker, transformed the prognosis of such patients [ 3 , 4 , 5 , 6 , 7 ]. With systemic dissemination being very rare [ 8 ], that prognosis is driven by two main factors: the post-CRS residual disease, rated by the Completeness of Cytoreduction score (CC-score) and the pathologic characteristics defining low- and high-grade disease [ 4 , 9 , 10 , 11 ]. As patients often present with diffuse disease, extensive resections are required to reach a complete CRS, including multiple digestive and peri-hepatic resections, leading to high rates of severe postoperative complications, which are prone to affecting patients’ quality of life and prognosis [ 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Scalloping of the Liver and Spleen on Preoperative CT-Scan of Pseudomyxoma Peritonei Patients: Impact on Prediction of Resectability, Grade, Morbidity and Survival

Képénékian

Kefleyesus

Keskin

et al. 2022

Cancers

View full text Add to dashboard Cite

Pseudomyxoma peritonei (PMP) is ideally treated by cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC), leading to significant morbidity. Beyond the histologic grade, the prognosis lies in the completeness of cytoreduction (CC-score of 0/1 vs. 2/3) and the severe complication rate. The mucinous nature of the peritoneal implants sometimes induces liver and/or spleen scalloping on imaging. The predictive value of scalloping was assessed regarding resectability, grade, survival and severe morbidity. This monocentric, retrospective analysis compared CC-0/1 with CC-2/3 groups regarding liver and spleen scalloping parameters, assessed on pre-operative computed tomography (CT) scan, reviewed for the study. In addition, prognostic factors of severe complications and recurrence-free and overall survivals were explored in the CC-0/1 population. Overall, 129 patients were included (109 CC-0/1, 20 CC-2/3), with 58 (45%) exhibiting scalloping. All patients with splenic scalloping also had a liver one. Scalloping was more frequent (75% vs. 39%), with greater median maximal depth (21 vs. 11 mm) and higher PCI (32 vs. 14) in the CC-2/3 population, but was not predictive of either grade or survival. In CC-0/1 patients, survivals and postoperative complications were not affected by scalloping parameters. Scalloping appeared as a marker of advanced PMP, but was not predictive of grade, severe complications, or long-term outcomes.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Scalloping of the Liver and Spleen on Preoperative CT-Scan of Pseudomyxoma Peritonei Patients: Impact on Prediction of Resectability, Grade, Morbidity and Survival

Képénékian

Kefleyesus

Keskin

et al. 2022

Cancers

View full text Add to dashboard Cite

show abstract

“…However, despite such aggressive intervention, recurrence rates after complete cytoreduction range from 24% to 30%. PMP relapsing or progressing after CRS/HIPEC were treated with curative-intent surgery or palliative options such as systemic chemotherapy [4].…”

Section: Introductionmentioning

confidence: 99%

A2AR Expression and Immunosuppressive Environment Independent of KRAS and GNAS Mutations in Pseudomyxoma Peritonei

et al. 2023

Self Cite

View full text Add to dashboard Cite

In pseudomyxoma peritonei (PMP), KRAS and GNAS mutations are frequent. We hypothesized that these mutations may contribute to the suppression of antitumor immunity: KRAS may induce GMCSF expression, while GNAS may enhance the expression of cyclic adenosine monophosphate and A2AR signaling. This study aimed to explore possible mechanisms facilitated by KRAS and GNAS mutations for escaping immune surveillance. Additionally, we looked for new potential therapeutic and prognostic targets in this rare disease which is poorly characterized at the molecular level. GM-CSF, A2AR, CD73, CD39, and PD-L1 expression was investigated by immunohistochemistry in 40 PMPs characterized for GNAS and KRAS mutational status. Immune cell populations were studied by immunohistochemistry and nanostring nCounter®. Following the criteria of a prognostic nomogram reported for PMP, we stratified the patients into two different risk groups, with 28 “low-risk” and 12 “high-risk” patients. We observed the expression of GM-CSF (74%); CD39 (37%); CD73 (53%); A2AR (74%); and PD-L1 (16%) which was unrelated to GNAS or KRAS status. The tumor microenvironment showed the presence of CD4+ T cells (86%); CD8+ T cells (27%); CD20+ B (67%); CD15+ cells (86%); and CD163+ M2 macrophages (67%), while CD56+ NK cells were absent. CD163 expression (27%) in PMP tumor cells was associated with poor prognosis. GNAS mutation and A2AR expression were not associated with a specific immune transcriptional signature. However, the expression assay revealed 21 genes associated with prognosis. The “high-risk” patients exhibited worse progression-free survival (HR = 2.3, CI 95%: 1.1–5.1, p = 0.034) and significant downregulation of MET, IL8, PPARG, DTX4, HMGA1, ZIC2, WNT5B, and CCRL2. In conclusion, we documented the presence of immunosuppressive factors such as GM-CSF, A2AR, and PD-L1 in PMP. These factors were not associated with GNAS and KRAS status and could be explored as therapeutic molecular targets. Additionally, a set of potential prognostic biomarkers, including CD163 expression in tumor cells, deserve further investigation.

show abstract

Peritoneal mesothelioma and pseudomyxoma peritonei

Gül,

Kuzinska,

Auer

et al. 2024

best practice onkologie

View full text Add to dashboard Cite

Systemic metastases from low-grade and high-grade pseudomyxoma peritonei: Treatments and outcomes

Cited by 7 publications

References 36 publications

Scalloping of the Liver and Spleen on Preoperative CT-Scan of Pseudomyxoma Peritonei Patients: Impact on Prediction of Resectability, Grade, Morbidity and Survival

Scalloping of the Liver and Spleen on Preoperative CT-Scan of Pseudomyxoma Peritonei Patients: Impact on Prediction of Resectability, Grade, Morbidity and Survival

A2AR Expression and Immunosuppressive Environment Independent of KRAS and GNAS Mutations in Pseudomyxoma Peritonei

Peritoneal mesothelioma and pseudomyxoma peritonei

Contact Info

Product

Resources

About