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Analysis of Treatment Failure after Complete Cytoreductive Surgery for Peritoneal Metastasis from Appendiceal Mucinous Neoplasm at a Japanese High Volume Center for Peritoneal Surface Malignancy

Authors :
Yutaka, Yonemura
Emel, Canbay
Satoshi, Wakama
Shouzou, Sako
Haruaki, Ishibashi
Masamitsu, Hirano
Shunsuke, Motoi
Akiyoshi, Mizumoto
Nobuyuki, Takao
Masumi, Ichinose
Kousuke, Noguchi
Yang, Liu
Sachio, Fushida
Yan, Li
Source :
Gan to kagaku ryoho. Cancerchemotherapy. 46(2)
Publication Year :
2019

Abstract

Treatment failure after complete cytoreduction for appendiceal mucinous carcinoma peritonei (AMCP)has not been fully investigated. The present study was performed to clarify the risk factor for recurrence after complete cytoreduction for AMCP.A total of 400 patients with AMCP who underwent complete cytoreductive surgery combined with perioperative chemotherapy were investigated.Documented recurrence was developed in 135 (33.8%)patients. The 5- and 10-year progression-free survival was 51% and 49%, respectively. By multivariate analysis, histological subtype of peritoneal disease(high-grade AMCP[AMCP-H]and AMCP-H with signet ring cells), serum CA19- 9 level, and PCIB20 were significantly associated with reduced progression-free survival. In contrast, histologic subtype of mucin without epithelial cells(MWEC)showed the lowest risk for recurrence. Eighty-six patients had localized intra-abdominal recurrence, and 42 patients had diffuse peritoneal recurrence. Recurrence was found in the various peritoneal sectors. Eighty-one patients underwent complete cytoreduction for the recurrence, and the overall survival 5-year survival rate after secondary cytoreduction was 49%.Risk factors for recurrence were histologic subtype, PCI cutoff level, and serum CA19-9 levels. Aggressive second attempt of cytoreduction in patients with localized recurrence improved the survival.

Details

ISSN :
03850684
Volume :
46
Issue :
2
Database :
OpenAIRE
Journal :
Gan to kagaku ryoho. Cancerchemotherapy
Accession number :
edsair.pmid..........bcbf683bb08e3fa51c8a4548043348b4