Treatment of advanced pseudomyxoma peritonei using cytoreductive surgery including total gastrectomy and perioperative chemotherapy

Sugarbaker, Paul H.; Chang, David

doi:10.1002/jso.26506

Cited by 11 publications

(8 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A recent report showed that the univariate analysis of poor prognosis in patients with peritoneal pseudomyxoma after neoplasm reduction included women (P = 0.0127), intestinal obstruction before treatment (P = 0.00791) and PSS (P = 0.0054). There was also a significant difference in PSS in multivariate analysis (P = 0.0041) 14 . Our results suggested that male postoperative survival was worse, but it was not an independent factor for the prognosis.…”

Section: Discussionmentioning

confidence: 83%

Prognostic prediction of preoperative nutritional status in low-grade appendiceal mucinous neoplasms

Wang

Shi

et al. 2022

Sci Rep

View full text Add to dashboard Cite

To describe the preoperative nutritional status of Low-grade Appendiceal Mucinous Neoplasms (LAMNs) and identify prognostic factors for survival. Medical records from 165 patients with LAMNs who attended the Aerospace Center Hospital, Beijing, China between January 2017, and December 2018 were retrospectively reviewed. Survival analysis was performed with the Kaplan–Meier method, the log-rank test, and a Cox proportional hazards model. Among 165 patients, 59 (36%) were male and 106 (64%) were female. Patient’s median age was 58 years (range 20 to 78 years). Univariate analysis indicated that gender, weight loss, prior surgical score (PSS), red blood cell, albumin, peritoneal cancer index (PCI), completeness of cytoreduction (CCR), and hyperthermic intraperitoneal chemotherapy (HIPEC) were related to prognosis. Multivariate analysis showed that PSS, CCR and HIPEC were independent predictors of prognosis. The preoperative nutritional status of patients plays an important role in predicting prognosis. Patients can benefit from a complete cytoreductive surgery (CCRS) and HIPEC in an experienced institution for the first medical treatment.

show abstract

Section: Discussionmentioning

confidence: 83%

Prognostic prediction of preoperative nutritional status in low-grade appendiceal mucinous neoplasms

Wang

Shi

et al. 2022

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Total gastrectomy has been described in the past as a requirement for complete cytoreduction 8,21 . If mucinous tumor cells entering through the Foramen of Winslow lodge in the cul‐de‐sac posterior to the gastric antrum, an antrectomy can be the procedure that facilitates the CC‐0/1 resection 22 .…”

Section: Discussionmentioning

confidence: 99%

“…Total gastrectomy has been described as a necessary requirement of complete CRS in selected patients with appendiceal mucinous tumors. This was associated with a 10‐year survival of 58% 8 . Also, total abdominal colectomy (TAC) has been used in this group of patients to facilitate a complete cytoreduction.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Total abdominal colectomy to facilitate complete cytoreduction in 56 patients with mucinous appendiceal neoplasms with peritoneal metastases

Sugarbaker

Chang

2023

Journal of Surgical Oncology

Self Cite

View full text Add to dashboard Cite

Background Cytoreductive surgery (CRS) and perioperative intraperitoneal chemotherapy are currently the standard of care for management of appendiceal mucinous neoplasms with peritoneal metastases. The goal of the CRS is complete removal of all visible disease through the use of peritonectomy procedures and visceral resections. One of the major resections that may be required is total abdominal colectomy (TAC). Methods From a database and secured files of patients having a complete CRS, all patients who had TAC were identified. The clinical and histologic variables associated with these patients were identified and assessed for their impact on overall survival. Results The 450 complete CRS with low‐grade appendiceal mucinous neoplasms had 26 TAC (5.8%) with a 16.0‐year median survival. The mucinous adenocarcinoma (MACA)‐Intermediate (MACA‐Int) group consisted of 37 patients with 8 patients (21.6%) having TAC that resulted in a median survival of 11.5 years. The 159 complete CRS with MACA had 22 TAC (13.8%) with a median survival of 7.5 years. There was a single mortality with a class 4 adverse event in 5 patients (10.7%). With a class 4 adverse event, survival decreased significantly (p = 0.0006, hazard ratio: 6.2). Conclusion Complete CRS required TAC in 56 of 646 patients (8.7%) with appendiceal mucinous neoplasms. With TAC, median survival was 12.0 years. A class 4 adverse event markedly reduced survival.

show abstract

“…As shown by our data on prior surgical score, the interventions that occur prior to definitive cytoreductive surgery plus perioperative chemotherapy have a profound effect on outcome [13] . Sugarbaker and Chang showed that the most detrimental clinical feature for survival of a MAN patient requiring an extensive cytoreduction was a prior diagnosis of ovarian cancer [18] . These women had an error in diagnosis of ovarian cancer but, in reality had MAN.…”

Section: Discussionmentioning

confidence: 99%

Progression of perforated cystadenoma of the appendix to pseudomyxoma peritonei over 18 years. A case report

Sugarbaker¹

2022

International Journal of Surgery Case Reports

Self Cite

View full text Add to dashboard Cite

Introduction and importance In the past, mucinous appendiceal neoplasms (MAN) greater than 2 cm in diameter were treated by a right colon resection. New data shows that treatment options are to be determined by the histopathologic grade of the appendiceal tumor and the condition of the wall of the appendix (intact vs. breached). Case presentation A 39-year-old woman had an incidental diagnosis of a low-grade appendiceal mucinous neoplasm (LAMN) at the time of a hysterectomy. The appendiceal tumor had small quantities of mucus surrounding an enlarged appendix. No tumor cells were seen in the mucus by histologic study. The patient was placed in follow-up. Eighteen years later she required treatment for advanced pseudomyxoma peritonei. Clinical discussion When 5 different histopathologic types of MAN are considered with an intact vs. perforated wall of the appendix, four different treatment options develop. With LAMN and well or moderately differentiated mucinous appendiceal adenocarcinoma (MACA), the patient does not require operative intervention if the wall of the appendix is intact. If mucus or mucus plus tumor cells are identified outside the appendix an intervention is indicated. In patients, as the one presented, in whom only small amounts of mucus are outside the appendix, surveillance may be recommended. Conclusions In patients with a diagnosed low-grade MAN, dissemination to regional lymph nodes is rare. Dissemination to the peritoneal space places the patient at risk to develop pseudomyxoma peritonei. As this case report illustrates, if surveillance is recommended, long-term follow-up is required.

show abstract

Treatment of advanced pseudomyxoma peritonei using cytoreductive surgery including total gastrectomy and perioperative chemotherapy

Cited by 11 publications

References 27 publications

Prognostic prediction of preoperative nutritional status in low-grade appendiceal mucinous neoplasms

Prognostic prediction of preoperative nutritional status in low-grade appendiceal mucinous neoplasms

Total abdominal colectomy to facilitate complete cytoreduction in 56 patients with mucinous appendiceal neoplasms with peritoneal metastases

Progression of perforated cystadenoma of the appendix to pseudomyxoma peritonei over 18 years. A case report

Contact Info

Product

Resources

About