Early- and long-term outcome data of patients with pseudomyxoma peritonei from appendiceal origin treated by a strategy of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy
- PMID: 22614976
- DOI: 10.1200/JCO.2011.39.7166
Early- and long-term outcome data of patients with pseudomyxoma peritonei from appendiceal origin treated by a strategy of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy
Abstract
Purpose: Pseudomyxoma peritonei (PMP) originating from an appendiceal mucinous neoplasm remains a biologically heterogeneous disease. The purpose of our study was to evaluate outcome and long-term survival after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) consolidated through an international registry study. VSports手机版.
Patients and methods: A retrospective multi-institutional registry was established through collaborative efforts of participating units affiliated with the Peritoneal Surface Oncology Group International V体育安卓版. .
Results: Two thousand two hundred ninety-eight patients from 16 specialized units underwent CRS for PMP. Treatment-related mortality was 2% and major operative complications occurred in 24% of patients. The median survival rate was 196 months (16. 3 years) and the median progression-free survival rate was 98 months (8. 2 years), with 10- and 15-year survival rates of 63% and 59%, respectively. Multivariate analysis identified prior chemotherapy treatment (P < . 001), peritoneal mucinous carcinomatosis (PMCA) histopathologic subtype (P < . 001), major postoperative complications (P = . 008), high peritoneal cancer index (P = V体育ios版. 013), debulking surgery (completeness of cytoreduction [CCR], 2 or 3; P < . 001), and not using HIPEC (P = . 030) as independent predictors for a poorer progression-free survival. Older age (P = . 006), major postoperative complications (P < . 001), debulking surgery (CCR 2 or 3; P < . 001), prior chemotherapy treatment (P = . 001), and PMCA histopathologic subtype (P < . 001) were independent predictors of a poorer overall survival. .
Conclusion: The combined modality strategy for PMP may be performed safely with acceptable morbidity and mortality in a specialized unit setting with 63% of patients surviving beyond 10 years. Minimizing nondefinitive operative and systemic chemotherapy treatments before definitive cytoreduction may facilitate the feasibility and improve the outcome of this therapy to achieve long-term survival. Optimal cytoreduction achieves the best outcomes VSports最新版本. .
Comment in
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"VSports在线直播" Pseudomyxoma peritonei: more questions than answers.J Clin Oncol. 2012 Jul 10;30(20):2429-30. doi: 10.1200/JCO.2012.42.3764. Epub 2012 May 21. J Clin Oncol. 2012. PMID: 22614983 No abstract available.
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Avoiding a throwback to the past.J Clin Oncol. 2013 Jan 20;31(3):396-7. doi: 10.1200/JCO.2012.46.0675. Epub 2012 Dec 26. J Clin Oncol. 2013. PMID: 23269997 No abstract available.
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Reply to P.H. Sugarbaker.J Clin Oncol. 2013 Jan 20;31(3):397-8. doi: 10.1200/JCO.2012.46.7365. J Clin Oncol. 2013. PMID: 23451355 No abstract available.
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