The results of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in 1200 patients with peritoneal malignancy

Moran, Brendan; Cecil, Thomas D.; Chandrakumaran, Kandiah; Arnold, Steve; Mohamed, Faheez; Venkatasubramaniam, Arcot

doi:10.1111/codi.12975

Cited by 84 publications

(63 citation statements)

References 28 publications

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“…The authors concluded that the 10-year OS rate after CRS and HIPEC was more than 63%. Moran et al [24] have just recently shown a 5-year OS rate of 84% in patients with appendiceal tumours and PMP who had complete cytoreduction. In our cohort, the 5-year OS for patients with PMP was only 62%.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Outcomes after Surgery for Appendiceal Mucinous Tumours

Dulskas

Poškus

et al. 2017

Visc Med

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Background: Appendiceal mucinous tumour (AMT) is a very uncommon disease. We aimed to evaluate preoperative and postoperative characteristics as well as long-term outcomes of patients with appendiceal mucinous adenomas and peritoneal pseudomyxoma (PMP). Methods: A consecutive cohort of patients diagnosed with AMT were included in the study. Tumour recurrence and the development of PMP was diagnosed based on the patients' complaints, physical examination, imaging studies, and biopsy results. The calculation of survival rates was performed using the Kaplan-Meier method. Results: Between January 2003 and February 2013, 25 patients had AMT. 15 patients underwent appendectomy only (60%), 5 patients (20%) right hemicolectomy, 4 patients (16%) cytoreductive surgery (CRS) ± hyperthermic intraperitoneal chemotherapy (HIPEC), and 1 patient (4%) appendectomy with caecal resection. Another 2 patients underwent CRS and HIPEC 4 days and 3 years, respectively, following initial appendectomy. In the histopathologic examination, adenoma was diagnosed in 12 patients (48%); among these, low-grade PMP was found in 1 patient (4%). Low-grade appendiceal mucinous adenocarcinoma (AMCa) was diagnosed in 11 patients (44%); among these, low-grade PMP was found in seven cases (28%) and high-grade AMCa was diagnosed in 2 patients (8%). 2 of 8 PMP patients did not undergo CRS ± HIPEC because of comorbidities. The 5-year overall survival was 100% for the adenomas and 62% for PMP patients. Conclusion: AMT is a very rare entity with a considerably good outcome even in disseminated disease. CRS and HIPEC is a gold standard treatment for PMP with excellent prognosis. However, our results could still be improved in the future.

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Section: Discussionmentioning

confidence: 99%

Long-Term Outcomes after Surgery for Appendiceal Mucinous Tumours

Dulskas

Poškus

et al. 2017

Visc Med

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“…Moran et al [13] have reported a 5-year survival rate of 84% after complete resection for patients with appendiceal cancer. In the present study, the 5-year survival rate for patients with appendiceal cancer was 70.0%, regardless of the cytoreduction score.…”

Section: Discussionmentioning

confidence: 99%

Experiences with cytoreduction surgery plus hyperthermic intraperitoneal chemotherapy in Taiwan

Hsieh

Chang

et al. 2017

Medicine

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Our hospital was the first institution to offer cytoreduction surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) in Taiwan. Therefore, we report our experience and outcomes among patients who underwent HIPEC.Since 2002, 164 eligible patients underwent HIPEC, and we excluded cases of laparoscopic or prophylactic HIPEC. The cases were categorized according to whether they were treated before 2012 (Period 1: 80 cases) or after 2012 (Period 2: 84 cases).The rates of surgical morbidity were 46.3% during Period 1 and 20.2% during Period 2 (P < .01), and the rates of severe complications were 25% during Period 1 and 9.5% during Period 2 (P < .01). The 5-year overall survival rate was 35.8%, with rates of 13.4% for gastric cancer, 27.3% for colon cancer, 70.0% for appendiceal cancer, and 52.4% for ovarian cancer (median follow-up: 34 months). The survival rate was 42.1% when we achieved a cytoreduction score of 0/1, compared with 21.1% in the group with a cytoreduction score of 2/3 (P < .01). Severe complications were associated with a 5-year survival rate of 23.4%, compared with 37.9% among cases without severe complications (P = .01). Complete cytoreduction was achieved in 78.6% of the patients if they underwent their first surgery at our hospital.We have become an experienced hospital for CRS plus HIPEC. Although our complication rate for CRS plus HIPEC was high, it was within the acceptable range. Long-term survival was achieved in a few cases.

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“…In lower gastrointestinal tumors including appendix cancer, colon cancer, and rectal cancer, CRS can be beneficial if the PCI is low and the morphology of the PSM is mucinous. Especially in mucinous PSM, even patients with a high PCI are accepted for CRS [10].…”

Section: Introductionmentioning

confidence: 99%

Oligometastatic Disease in the Peritoneal Space with Gastrointestinal Cancer

Rau¹,

Brandl²,

Pascher³

et al. 2017

Visc Med

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Objectives: Treatment options for patients with gastrointestinal cancer and oligometastastic disease remain the domain of the medical oncologist. However, in selected cases, attempts to remove or destroy the tumor burden seem appropriate. Background Data: During the last decade, the treatment of localized and isolated tumor nodules, such as lung, liver or peritoneal metastasis, has changed. Previously, these patients with metastatic disease only received palliative chemotherapy. Combined treatment approaches and new techniques demonstrate that additional surgery to destroy or remove the metastases seem to be of major benefit to patients. Methods: The recently published important literature regarding peritoneal metastases and oligometastases in gastrointestinal cancer was analyzed. Results: The most important factor in the treatment of peritoneal metastases and in cytoreductive surgery is patient selection. Resection of peritoneal metastases should be considered. Hyperthermic intraperitoneal chemotherapy is feasible. However, further results of randomized trials are necessary. Several randomized trials are on the way and will be available in 1-2 years. Systemic chemotherapy alone as an adequate management plan for all sites of metastatic disease is not compatible with a high standard of care. Formulating an optimal plan combining re-operative surgery with regional plus systemic chemotherapy is a necessary task of the multidisciplinary team. Conclusions: In oligometastastic disease of gastrointestinal cancer origin, the selection process is the most important factor for survival. Further studies are needed to determine optimal treatment options.

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The results of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in 1200 patients with peritoneal malignancy

Abstract: A centralized approach facilitated high volume experience in a single centre with an increase in the completeness of surgical excision rates and a reduction in mortality and morbidity over time.

Cited by 84 publications

References 28 publications

Long-Term Outcomes after Surgery for Appendiceal Mucinous Tumours

Long-Term Outcomes after Surgery for Appendiceal Mucinous Tumours

Experiences with cytoreduction surgery plus hyperthermic intraperitoneal chemotherapy in Taiwan

Oligometastatic Disease in the Peritoneal Space with Gastrointestinal Cancer

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