Systemic Chemotherapy prior to Cytoreductive Surgery and HIPEC for Carcinomatosis from Appendix Cancer: Impact on Perioperative Outcomes and Short-Term Survival
Background and Objectives. Systemic chemotherapy administered prior to cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal mucinous adenocarcinoma of appendiceal origin (PMCA) is associated with a significant rate of histological response. The impact of preoper...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2012-01-01
|
| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2012/163284 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832558398328012800 |
|---|---|
| author | Lana Bijelic Anjali S. Kumar O. Anthony Stuart Paul H. Sugarbaker |
| author_facet | Lana Bijelic Anjali S. Kumar O. Anthony Stuart Paul H. Sugarbaker |
| author_sort | Lana Bijelic |
| collection | DOAJ |
| description | Background and Objectives. Systemic chemotherapy administered prior to cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal mucinous adenocarcinoma of appendiceal origin (PMCA) is associated with a significant rate of histological response. The impact of preoperative systemic chemotherapy (PSC) on intraperitoneal tumor burden, completeness of cytoreduction, and perioperative complications is unknown. Methods. We analyzed prospectively collected data from our HIPEC database. Thirty-four patients with PMCA were prospectively recruited and treated with PSC. Perioperative variables and survival in this group of patients were compared against 24 patients with PMCA who did not receive PSC. Results. Ten of 34 patients (29%) receiving PSC had a complete or near complete histological response. Patients receiving PSC had a lower peritoneal carcinomatosis index, required fewer peritonectomies and visceral resections, and achieved complete cytoreduction more frequently compared to patients with no preoperative chemotherapy. The incidence of perioperative complications and survival were not significantly different between the two groups. However, patients with complete histological response had better overall survival compared to patients without complete response. Conclusions. Preoperative systemic chemotherapy in appendix-originated PMCA is associated with a significant rate of histological response which may reduce the tumor burden, facilitate less aggressive and more complete CRS, and improve short-term survival in patients with a significant histological response. |
| format | Article |
| id | doaj-art-9188711e1991468a97eae9b6c8d60ca5 |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-9188711e1991468a97eae9b6c8d60ca52025-02-03T01:32:33ZengWileyGastroenterology Research and Practice1687-61211687-630X2012-01-01201210.1155/2012/163284163284Systemic Chemotherapy prior to Cytoreductive Surgery and HIPEC for Carcinomatosis from Appendix Cancer: Impact on Perioperative Outcomes and Short-Term SurvivalLana Bijelic0Anjali S. Kumar1O. Anthony Stuart2Paul H. Sugarbaker3Section of Surgical Oncology, Department of Surgery, Washington Hospital Center, 110 Irving Street, Washington, DC 20010, USASection of Colon and Rectal Surgery, Washington Hospital Center, 110 Irving Street, Washington, DC 20010, USAMedstar Health Research Institute, Washington Hospital Center, 110 Irving Street, Washington, DC 20010, USASection of Surgical Oncology, Department of Surgery, Washington Hospital Center, 110 Irving Street, Washington, DC 20010, USABackground and Objectives. Systemic chemotherapy administered prior to cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal mucinous adenocarcinoma of appendiceal origin (PMCA) is associated with a significant rate of histological response. The impact of preoperative systemic chemotherapy (PSC) on intraperitoneal tumor burden, completeness of cytoreduction, and perioperative complications is unknown. Methods. We analyzed prospectively collected data from our HIPEC database. Thirty-four patients with PMCA were prospectively recruited and treated with PSC. Perioperative variables and survival in this group of patients were compared against 24 patients with PMCA who did not receive PSC. Results. Ten of 34 patients (29%) receiving PSC had a complete or near complete histological response. Patients receiving PSC had a lower peritoneal carcinomatosis index, required fewer peritonectomies and visceral resections, and achieved complete cytoreduction more frequently compared to patients with no preoperative chemotherapy. The incidence of perioperative complications and survival were not significantly different between the two groups. However, patients with complete histological response had better overall survival compared to patients without complete response. Conclusions. Preoperative systemic chemotherapy in appendix-originated PMCA is associated with a significant rate of histological response which may reduce the tumor burden, facilitate less aggressive and more complete CRS, and improve short-term survival in patients with a significant histological response.http://dx.doi.org/10.1155/2012/163284 |
| spellingShingle | Lana Bijelic Anjali S. Kumar O. Anthony Stuart Paul H. Sugarbaker Systemic Chemotherapy prior to Cytoreductive Surgery and HIPEC for Carcinomatosis from Appendix Cancer: Impact on Perioperative Outcomes and Short-Term Survival Gastroenterology Research and Practice |
| title | Systemic Chemotherapy prior to Cytoreductive Surgery and HIPEC for Carcinomatosis from Appendix Cancer: Impact on Perioperative Outcomes and Short-Term Survival |
| title_full | Systemic Chemotherapy prior to Cytoreductive Surgery and HIPEC for Carcinomatosis from Appendix Cancer: Impact on Perioperative Outcomes and Short-Term Survival |
| title_fullStr | Systemic Chemotherapy prior to Cytoreductive Surgery and HIPEC for Carcinomatosis from Appendix Cancer: Impact on Perioperative Outcomes and Short-Term Survival |
| title_full_unstemmed | Systemic Chemotherapy prior to Cytoreductive Surgery and HIPEC for Carcinomatosis from Appendix Cancer: Impact on Perioperative Outcomes and Short-Term Survival |
| title_short | Systemic Chemotherapy prior to Cytoreductive Surgery and HIPEC for Carcinomatosis from Appendix Cancer: Impact on Perioperative Outcomes and Short-Term Survival |
| title_sort | systemic chemotherapy prior to cytoreductive surgery and hipec for carcinomatosis from appendix cancer impact on perioperative outcomes and short term survival |
| url | http://dx.doi.org/10.1155/2012/163284 |
| work_keys_str_mv | AT lanabijelic systemicchemotherapypriortocytoreductivesurgeryandhipecforcarcinomatosisfromappendixcancerimpactonperioperativeoutcomesandshorttermsurvival AT anjaliskumar systemicchemotherapypriortocytoreductivesurgeryandhipecforcarcinomatosisfromappendixcancerimpactonperioperativeoutcomesandshorttermsurvival AT oanthonystuart systemicchemotherapypriortocytoreductivesurgeryandhipecforcarcinomatosisfromappendixcancerimpactonperioperativeoutcomesandshorttermsurvival AT paulhsugarbaker systemicchemotherapypriortocytoreductivesurgeryandhipecforcarcinomatosisfromappendixcancerimpactonperioperativeoutcomesandshorttermsurvival |