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Surgical cytoreduction and survival in appendiceal cancer peritoneal carcinomatosis: an evaluation of 46 consecutive patients.
- Source :
-
Annals of surgical oncology [Ann Surg Oncol] 2011 Jun; Vol. 18 (6), pp. 1540-6. Date of Electronic Publication: 2011 Apr 14. - Publication Year :
- 2011
-
Abstract
- Background: Surgical cytoreduction and intraperitoneal chemotherapy is increasingly accepted as an effective treatment modality for mucinous appendiceal neoplasm. For the majority of patients with low-grade histology, outcomes have been encouraging. The survival of patients with neoplasms of malignant character is protracted and this study was designed to evaluate the effectiveness of this surgical strategy on outcomes.<br />Methods: Forty-six consecutive patients with mucinous and nonmucinous appendiceal cancer with peritoneal dissemination were studied. Clinicopathological and treatment related factors were obtained from a prospective database. The study's end points of disease-free survival (DFS) and overall survival (OS) were analyzed using the Kaplan-Meier method.<br />Results: The median DFS and OS after cytoreduction were 20.5 and 56.4 months respectively. Five-year overall survival rate was 45%. Five independent factors associated with DFS and OS were identified through a multivariate analysis: age (DFS p = 0.001, OS p = 0.002), completeness of cytoreduction (DFS p = 0.001, OS p = 0.003), previous chemotherapy treatment (DFS p = 0.021), CA 199 levels (DFS p = 0.013), and tumor grade (OS p = 0.005).<br />Conclusions: Cytoreductive surgery and intraperitoneal chemotherapy may achieve long-term survival in appendiceal malignancies with peritoneal dissemination for which the predictors of outcomes identified through this study may tailor the disease management to commit patients early toward this successful surgical strategy.
- Subjects :
- Adenocarcinoma, Mucinous secondary
Adenocarcinoma, Mucinous surgery
Adult
Aged
Appendiceal Neoplasms pathology
Appendiceal Neoplasms surgery
Combined Modality Therapy
Female
Humans
Male
Middle Aged
Peritoneal Neoplasms secondary
Peritoneal Neoplasms surgery
Prospective Studies
Survival Rate
Treatment Outcome
Adenocarcinoma, Mucinous mortality
Adenocarcinoma, Mucinous therapy
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Appendiceal Neoplasms mortality
Appendiceal Neoplasms therapy
Peritoneal Neoplasms mortality
Peritoneal Neoplasms therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1534-4681
- Volume :
- 18
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Annals of surgical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 21491165
- Full Text :
- https://doi.org/10.1245/s10434-011-1714-3