Secondary cytoreductive surgery for lymph node positive mucinous appendiceal neoplasms |
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| Affiliation: | 1. Program in Peritoneal Surface Malignancy, Washington Cancer Institute, Washington, DC, USA;2. Westat, Rockville, MD, USA;1. Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan;2. Department of Surgery, Iizuka Hospital, 3-83 Yoshiomachi, Iizuka City, Fukuoka, 820-8505, Japan;3. Department of Hepatobiliary-Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, Notame 3-1-1, Minami-ku, Fukuoka, 811-1395, Japan;4. Department of Surgery, Matsuyama Red Cross Hospital, Bunkyo-cho, Matsuyama-shi, Ehime, 790-8524, Japan;5. Department of Surgery, Oita Red Cross Hospital, 3-2-37, Chiyo-machi, Oita, Oita, 870-0033, Japan;6. Department of Surgery, National Hospital Organization Kumamoto Medical Center, 1-5 Ninomaru, Chuo-ku, Kumamoto, 860-0008, Japan;7. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan;8. Department of Surgery, Saiseikai Kumamoto Hospital, 5-3-1 Chikami, Minami-ku, Kumamoto, 861-4193, Japan;1. Medical College, The Aga Khan University Hospital, Stadium Road, Karachi, 74800, Pakistan;2. Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA;1. Department of Surgery, Canisius-Wilhelmina Hospital, Weg Door Jonkerbos 100, 6532SB, Nijmegen, the Netherlands;2. Department of Surgery, Queen Beatrix Hospital, Beatrixpark 1, 7101 BN, Winterswijk, the Netherlands;3. Department of Pathology, Canisius-Wilhelmina Hospital, Weg Door Jonkerbos 100, 6532SB, Nijmegen, the Netherlands;4. Department of Surgery, Radboud University Medical Centre, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, the Netherlands;1. Department of Internal Medicine, University of Health Sciences, Taksim Research and Training Hospital, Istanbul, Turkey;2. Department of Medical Oncology, University of Health Sciences, Van Research and Training Hospital, Van, Turkey;3. Department of Medical Oncology, Yuzuncu Yil University Medical School, 65030, Van, Turkey;4. İstanbul Medipol University, General Surgery Department, Istanbul, Turkey;5. Department of Pathology, Yuzuncu Yil University Medical School, 65030, Van, Turkey;6. Department of General Surgery, Yuzuncu Yil University Medical School, 65030, Van, Turkey;7. İstanbul Medipol University, Medical Oncology Department, Istanbul, Turkey;1. University of Maryland Medical Center, Department of General Surgery, USA;2. University of Maryland Baltimore, Department of Pharmaceutical Health Services Research, USA;3. University of Maryland Medical Center, Department of Gastroenterology, USA;4. Maryland Surgery, Pharmacy, and Anesthesiology Research Collaborative, USA |
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| Abstract: | BackgroundPatients who have surgery for a gastrointestinal cancer routinely have clinical and radiological tests in an effort to detect recurrent disease. If cancer progression is documented, additional surgery performed in a timely manner may prolong survival and help maintain an optimal quality of life. In mucinous appendiceal cancer patients a secondary cytoreductive surgery (SCRS) may be considered if recurrent disease is detected.MethodsIn patients with both lymph node metastases and peritoneal metastases from a mucinous appendiceal adenocarcinoma (MACA-LN) who had a prior complete cytoreductive surgery (CRS), the clinical- and treatment-related variables associated with the index CRS and the SCRS were extracted from a database and secured research files. These variables were statistically assessed for their impact on survival.ResultsTwelve of 39 lymph node positive patients (30.8%) had SCRS. The mean follow-up was 7.6 years and the median survival was 4.5 years. There were 4 males (33%) and median age was 44 years. Significant prognostic variables associated with improved survival with the index CRS by univariant analysis was the use of early postoperative intraperitoneal chemotherapy (EPIC) (p = 0.0469). For the SCRS, no significant prognostic variables, not even completeness of cytoreduction, were discovered.ConclusionsIn MACA-LN patients, improved survival with SCRS was shown as compared to patients who recurred but did not undergo SCRS. In this group of patients with an aggressive disease, if SCRS was possible it improved survival with long-term (greater than 5 years) follow-up. |
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| Keywords: | HIPEC EPIC Peritoneal metastases Peritonectomy Reoperation HITOC HIPEC" },{" #name" :" keyword" ," $" :{" id" :" pc_XJtVXyBlze" }," $$" :[{" #name" :" text" ," _" :" Hyperthermic intraperitoneal chemotherapy EPIC" },{" #name" :" keyword" ," $" :{" id" :" pc_jt0Tk7DOQu" }," $$" :[{" #name" :" text" ," _" :" Early postoperativeintraperitoneal chemotherapy HITOC" },{" #name" :" keyword" ," $" :{" id" :" pc_3dLSSzEMQI" }," $$" :[{" #name" :" text" ," _" :" Hyperthermic intrathoracic chemotherapy |
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