The Chicago Consensus on peritoneal surface malignancies: Management of appendiceal neoplasms

Schuitevoerder, Darryl; Plana, Alejandro; Izquierdo, Francisco J.; Votanopoulos, Konstantinos I.; Cusack, James C.; Bijelić, Lana; Cho, Clifford S.; Gangi, Alexandra; Gilbert, Erin W.; Goodman, Martin; Govindarajan, Anand; Gushchin, Vadim; Ihemelandu, Chukwuemeka; Kelly, Kaitlyn J.; Merkow, Ryan P.; Pappas, Sam G.; Abbott, Daniel E.; Ahrendt, Steven A.; Al‐Kasspooles, Mazin; Alpert, Lindsay; Amersi, Farin; Arrington, Amanda K.; Badgwell, Brian D.; Barone, Robert M.; Baumgartner, Joel M.; Blazer, Dan G.; Berri, Richard N.; Brown, Charles K.; Catenacci, Daniel V.T.; Chan, Carlos; Choudry, M. Haroon A.; Clarke, Callisia N.; Cloyd, Jordan M.; Dachman, Abraham H.; Deneve, Jeremiah L.; Dineen, Seán; Fernandez, Leopoldo; Eng, Oliver S.; Fleshman, James W.; Gamblin, T. Clark; Georgakis, Georgios V.; Grotz, Travis E.; Hanna, Nader; Harmath, Carla; Hart, John; Hayes‐Jordan, Andrea; Husain, Aliya N.; Idrees, Kamran; In, Haejin; Jiang, David; Kane, John M.; Kennedy, Timothy J.; Keutgen, Xavier M.; Kindler, Hedy L.; Lee, Byrne; Liao, Chih‐Yi; Maduekwe, Ugwuji N.; Mak, Grace Z.; Mack, Lloyd A.; Mathew, Melvy Sarah; Melis, Marcovalerio; Melnitchouk, Nelya; Misdraji, Joseph; Mogal, Harveshp; Möller, Mecker G.; Nash, Garrett M.; Oto, Aytekin; Pai, Reetesh K.; Pameijer, Colette R.; Polanco, Patricio M.; Polite, Blasé N.; Reddy, Sanjay S.; Royal, Richard E.; Ryan, David P.; Salti, George I.; Sardi, Armando; Senthil, Maheswari; Setia, Namrata; Sherman, Scott K.; Sidéris, Lucas; Skitzki, Joseph J.; Veerapong, Jula; White, Michael G.; Winer, Joshua H.; Xiao, Shu‐Yuan; Yantiss, Rhonda K.; Ahuja, Nita; Bowne, Wilbur B.; Lowy, Andrew M.; Alexander, H. Richard; Esquivel, Jesús; Foster, Jason M.; Labow, Daniel M.; Lambert, Laura; Levine, Edward A.; Staley, Charles A.; Sugarbaker, Paul H.; Bartlett, David L.; Turaga, Kiran K.

doi:10.1002/cncr.32881

Cited by 48 publications

(25 citation statements)

References 34 publications

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“…The treatment algorithm proposed by the SPCG is illustrated in Figure 1 . These recommendations are consistent with the current guidelines of the Peritoneal Surface Oncology Group International (PSOGI) and with most national guidelines [ 54 ].…”

Section: Resultssupporting

confidence: 83%

Comprehensive Treatment Algorithms of the Swiss Peritoneal Cancer Group for Peritoneal Cancer of Gastrointestinal Origin

Adamina

Warlaumont

Berger

et al. 2022

Cancers

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Peritoneal cancer (PC) is a dire finding, yet in selected patients, long-term survival is possible. Complete cytoreductive surgery (CRS) together with combination immunochemotherapy is essential to achieve cure. Hyperthermic intraperitoneal chemotherapy (HIPEC) and pressurized intraperitoneal aerosol chemotherapy (PIPAC) are increasingly added to the multimodal treatment. The Swiss Peritoneal Cancer Group (SPCG) is an interdisciplinary group of expert clinicians. It has developed comprehensive treatment algorithms for patients with PC from pseudomyxoma peritonei, peritoneal mesothelioma, gastric, and colorectal origin. They include multimodal neoadjuvant treatment, surgical resection, and palliative care. The indication for and results of CRS HIPEC and PIPAC are discussed in light of the current literature. Institutional volume and clinical expertise required to achieve best outcomes are underlined, while inclusion of patients considered for CRS HIPEC and PIPAC in a clinical registry is strongly advised. The present recommendations are in line with current international guidelines and provide the first comprehensive treatment proposal for patients with PC including intraperitoneal chemotherapy. The SPCG comprehensive treatment algorithms provide evidence-based guidance for the multimodal care of patients with PC of gastrointestinal origin that were endorsed by all Swiss clinicians routinely involved in the multimodal care of these challenging patients.

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Section: Resultssupporting

confidence: 83%

Comprehensive Treatment Algorithms of the Swiss Peritoneal Cancer Group for Peritoneal Cancer of Gastrointestinal Origin

Adamina

Warlaumont

Berger

et al. 2022

Cancers

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show abstract

“…Currently, CRS and HIPEC is regarded as standard of care for the treatment of PMP. 5 Recently, e cacy and survival bene t using HIPEC was reported by van Driel et al when implemented as a treatment strategy during interval cytoreduction for stage III epithelial ovarian cancer in a multicenter, randomized, phase 3 trial. 17 Moreover, this treatment approach has shown particular bene t for abdominal malignancies that include peritoneal mesothelioma, colorectal, and gastric carcinomas.…”

Section: Discussionmentioning

confidence: 98%

“…4 Computed tomography (CT), magnetic resonance imaging (MRI) and expert pathologic review are mandatory to establish PMP diagnosis prior to commencing with treatment. 5 De nitive treatment for PMP is complete gross resection and/or cytoreductive surgical (CRS) removal of all visible macroscopic tumor burden followed by hyperthermic intraperitoneal chemotherapy (HIPEC). 5,6 CRS and HIPEC is a complex surgical procedure that requires a multidisciplinary team approach.…”

Section: Introductionmentioning

confidence: 99%

“…5 De nitive treatment for PMP is complete gross resection and/or cytoreductive surgical (CRS) removal of all visible macroscopic tumor burden followed by hyperthermic intraperitoneal chemotherapy (HIPEC). 5,6 CRS and HIPEC is a complex surgical procedure that requires a multidisciplinary team approach. 7 At our institution, a specialized team of surgeons routinely provides this treatment in our appendix derived PMP patients with optimal oncologic outcomes and low morbidity.…”

Section: Introductionmentioning

confidence: 99%

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Rare Occurrence of Pseudomyxoma Peritonei (PMP) Syndrome Arising from a Malignant Transformed Ovarian Primary Mature Cystic Teratoma Treated by Cytoreductive Surgery and HIPEC: A Case Report

Ponzini

Kowal

Ghafoor

et al. 2022

Preprint

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Background: Pseudomyxoma peritonei (PMP) syndrome is a disease process that typically occurs from ruptured appendiceal mucocele neoplasms. PMP syndrome arising from malignant transformation of an ovarian primary mature cystic teratoma (MCT) is a pathogenesis rarely encountered. Case Presentation: Herein, we report a twenty-eight-year-old patient evaluated and treated for a right ovarian mass and large volume symptomatic abdominopelvic mucinous ascites. Molecular profiling and genetic analysis revealed mutations in ATM, GNAS, and KRAS proteins while IHC demonstrated gastrointestinal specific staining for CK20, CDX2, CK7 and SATB2. Peritoneal cytology showed paucicellular mucin. Diffuse peritoneal adenomucinosis (DPAM) variant of PMP arising from a ruptured ovarian primary MCT after malignant transformation to a low grade appendiceal-like mucinous neoplasm was ultimately confirmed. Treatment included staged therapeutic tumor debulking and right salpingo-oophorectomy followed by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). Conclusions: Our report builds upon the existing literature supporting this aggressive treatment option reserved for advanced abdominal malignancies utilized in this patient with a rare clinical entity.

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“…As per the Chicago consensus, indications of CRS and HIPEC in APM include (i) LAMN, (ii) appendicular adenocarcinoma, and (iii) goblet cell carcinoma [ 29 ]. In a retrospective study of 2298 patients, Chua et al reported 10 years survival of 63%, with a post-operative complication rate of 24% and a reoperation rate of 10% [ 30 ].…”

Section: Methodsmentioning

confidence: 99%

A proposal for changing nomenclature from pseudomyxoma peritonei (PMP) to abdomino-peritoneal mucinous carcinoma (APM) based on its long journey and experience from tertiary oncology center in India

et al. 2022

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Introduction Pseudomyxoma peritonei (PMP) is a generalized term, usually known as “jelly belly” since 1884. Incidence is very low, 1–3 per million people per year. Because of its indolent nature, it is usually diagnosed at an advanced stage, thereby impacting the quality of life. The 5-year survival rate varies from 23 to 86% in world literature. Even 10 years and 20 years of survival have been described. With our experience, we like to propose rename of PMP as abdomino-peritoneal mucinous carcinoma (APM) as we strongly feel the time has come to specify the term and standardize the management strategy. Methodology In the premier institute of India and as a tertiary referral center, we experienced the maximum number of advanced cases of APM. From 2012 to 2021, we analyzed all the APM patients based on a prospectively maintained computerized database in the department of surgical oncology and found the reasons for renaming from this traditional one. Results We included a total of 87 patients who underwent surgical intervention. Thirty-five patients underwent cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC), and 52 patients underwent debulking. In CRS-HIPEC patients, CC-0 was achieved in 28 patients (80%), CC-1 in 4 patients (11.4%), and CC-2 in 3 patients (8.6%). Palliative intent HIPEC was done in 3 patients (8.6%). Clavien-Dindo grade III and IV morbidity was observed in 18.8% of patients with 90 days mortality of 5.7%. Conclusion With our long-term experience and advancement of scientific evidence, we like to propose a new name for PMP as APM. We strongly believe this paper will give a clear picture of this rare disease and standard management outlines.

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The Chicago Consensus on peritoneal surface malignancies: Management of appendiceal neoplasms

Cited by 48 publications

References 34 publications

Comprehensive Treatment Algorithms of the Swiss Peritoneal Cancer Group for Peritoneal Cancer of Gastrointestinal Origin

Comprehensive Treatment Algorithms of the Swiss Peritoneal Cancer Group for Peritoneal Cancer of Gastrointestinal Origin

Rare Occurrence of Pseudomyxoma Peritonei (PMP) Syndrome Arising from a Malignant Transformed Ovarian Primary Mature Cystic Teratoma Treated by Cytoreductive Surgery and HIPEC: A Case Report

A proposal for changing nomenclature from pseudomyxoma peritonei (PMP) to abdomino-peritoneal mucinous carcinoma (APM) based on its long journey and experience from tertiary oncology center in India

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