Long term survival outcomes of surgery combined with hyperthermic intraperitoneal chemotherapy for perforated low-grade appendiceal mucinous neoplasms: A multicenter retrospective study.
Humans
Retrospective Studies
Male
Female
Appendiceal Neoplasms
/ therapy
Middle Aged
Hyperthermic Intraperitoneal Chemotherapy
Adult
Adenocarcinoma, Mucinous
/ therapy
Aged
Combined Modality Therapy
Treatment Outcome
Survival Rate
Neoplasm Grading
Intestinal Perforation
/ etiology
Peritoneal Neoplasms
/ therapy
HIEPC
perforated LAMN
survival prognosis
Journal
World journal of surgery
ISSN: 1432-2323
Titre abrégé: World J Surg
Pays: United States
ID NLM: 7704052
Informations de publication
Date de publication:
Jan 2024
Jan 2024
Historique:
received:
17
10
2023
accepted:
17
10
2023
medline:
30
4
2024
pubmed:
30
4
2024
entrez:
30
4
2024
Statut:
ppublish
Résumé
Low-grade appendiceal mucinous neoplasms (LAMN) are very rare, accounting for approximately 0.2%-0.5% of gastrointestinal tumors. We conducted a multicenter retrospective study to explore the impact of different surgical procedures combined with HIPEC on the short-term outcomes and long-term survival of patients. We retrospectively analyzed the clinicopathological data of 91 LAMN perforation patients from 9 teaching hospitals over a 10-year period, and divided them into HIPEC group and non-HIPEC group based on whether or not underwent HIPEC. Of the 91 patients with LAMN, 52 were in the HIPEC group and 39 in the non-HIPEC group. The Kaplan-Meier method predicted that 52 patients in the HIPEC group had 5- and 10-year overall survival rates of 82.7% and 76.9%, respectively, compared with predicted survival rates of 51.3% and 46.2% for the 39 patients in the non-HIPEC group, with a statistically significant difference between the two groups (χ This study shows that surgery combined with HIPEC can significantly improve 5-year and 10-year overall survival rates and relapse-free survival rates of LAMN perforation patients, without affecting their short-term clinical outcomes.
Sections du résumé
BACKGROUND
BACKGROUND
Low-grade appendiceal mucinous neoplasms (LAMN) are very rare, accounting for approximately 0.2%-0.5% of gastrointestinal tumors. We conducted a multicenter retrospective study to explore the impact of different surgical procedures combined with HIPEC on the short-term outcomes and long-term survival of patients.
METHODS
METHODS
We retrospectively analyzed the clinicopathological data of 91 LAMN perforation patients from 9 teaching hospitals over a 10-year period, and divided them into HIPEC group and non-HIPEC group based on whether or not underwent HIPEC.
RESULTS
RESULTS
Of the 91 patients with LAMN, 52 were in the HIPEC group and 39 in the non-HIPEC group. The Kaplan-Meier method predicted that 52 patients in the HIPEC group had 5- and 10-year overall survival rates of 82.7% and 76.9%, respectively, compared with predicted survival rates of 51.3% and 46.2% for the 39 patients in the non-HIPEC group, with a statistically significant difference between the two groups (χ
CONCLUSIONS
CONCLUSIONS
This study shows that surgery combined with HIPEC can significantly improve 5-year and 10-year overall survival rates and relapse-free survival rates of LAMN perforation patients, without affecting their short-term clinical outcomes.
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
86-96Commentaires et corrections
Type : ErratumIn
Informations de copyright
© 2023 International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).
Références
Gok, Mustafa, Ugur Topal, Muhammet Akyüz, Abdullah Bahadır Öz, Erdogan Sozuer, and Kemal Deniz. 2021. “Long‐term Results of Low Grade Appendiceal Mucinous Neoplasm (LAMN): A Retrospective Analysis of 24 Patients.” Archives of Iranian Medicine 24(8): 615–621. https://doi.org/10.34172/aim.2021.87.
Tiselius, Catarina, Csaba Kindler, Jayant Shetye, Henry Letocha, and Kenneth Smedh. 2017. “Computed Tomography Follow‐Up Assessment of Patients with Low‐Grade Appendiceal Mucinous Neoplasms: Evaluation of Risk for Pseudomyxoma Peritonei.” Annals of Surgical Oncology 24(7): 1778–1782. https://doi.org/10.1245/s10434‐016‐5623‐3.
Fleischmann, I, R Warschkow, U Beutner, L. Marti, B.M. Schmied, and T. Steffen. 2017. “Improved Survival after Retrieval of 12 or More Regional Lymph Nodes in Appendiceal Cancer.” European Journal of Surgical Oncology 43(10): 1876–1885. https://doi.org/10.1016/j.ejso.2017.06.015.
Istl, Alexandra C, Michele M Gage, Jesus Esquivel, Nita Ahuja, Jonathan B. Greer, and Fabian M. Johnston. 2021. “Management of Low‐Grade Appendiceal Mucinous Neoplasms (LAMN): An International Survey of Surgeons Performing CRS and HIPEC.” Annals of Surgical Oncology 28(7): 3831–3837. https://doi.org/10.1245/s10434‐020‐09312‐w.
Carr, Norman J, Thomas D Cecil, Faheez Mohamed, Leslie H. Sobin, Paul H. Sugarbaker, Santiago González‐Moreno, Panos Taflampas, et al. 2016. “A Consensus for Classification and Pathologic Reporting of Pseudomyxoma Peritonei and Associated Appendiceal Neoplasia: The Results of the Peritoneal Surface Oncology Group International (PSOGI) Modified Delphi Process.” The American Journal of Surgical Pathology 40(1): 14–26. https://doi.org/10.1097/pas.0000000000000535.
Xiao, Jianchun, Peiheng Li, and Wei Liu. 2021. “Analysis of Clinical Characteristics of Low‐Grade Appendiceal Mucinous Neoplasm (LAMN): A Retrospective Cohort Study of 51 LAMN Patients.” Journal of Investigative Surgery : The Official Journal of the Academy of Surgical Research 34(7): 721–727. https://doi.org/10.1080/08941939.2019.1695986.
Carr, Norman J, Frederic Bibeau, Robert F Bradley, Peggy Dartigues, Roger M Feakins, Kim R Geisinger, Xianyong Gui, et al. 2017. “The Histopathological Classification, Diagnosis and Differential Diagnosis of Mucinous Appendiceal Neoplasms, Appendiceal Adenocarcinomas and Pseudomyxoma Peritonei.” Histopathology 71(6): 847–858. https://doi.org/10.1111/his.13324.
Mittal, Rohin, Anuradha Chandramohan, and Brendan Moran. 2017. “Pseudomyxoma Peritonei: Natural History and Treatment.” International Journal of Hyperthermia : The Official Journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group 33(5): 511–519. https://doi.org/10.1080/02656736.2017.1310938.
Govaerts, K, RJ Lurvink, Ihjt de Hingh, K. van der Speeten, L. Villeneuve, S. Kusamura, V. Kepenekian, et al. 2021. “Appendiceal Tumours and Pseudomyxoma Peritonei: Literature Review with PSOGI/EURACAN Clinical Practice Guidelines for Diagnosis and Treatment.” European Journal of Surgical Oncology : The Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology 47(1): 11–35. https://doi.org/10.1016/j.ejso.2020.02.012.
Carr, Norman J, Theresa S Emory, and Leslie H Sobin. 2002. “Epithelial Neoplasms of the Appendix and Colorectum: an Analysis of Cell Proliferation, Apoptosis, and Expression of P53, CD44, Bcl‐2.” Archives of Pathology & Laboratory Medicine 126(7): 837–841. https://doi.org/10.5858/2002‐126‐0837‐enotaa.
Ronnett, Brigite M, Christopher M Zahn, Robert J Kurman, Mary E. Kass, Paul H. Sugarbaker, and Barry M. Shmookler. 1995. “Disseminated Peritoneal Adenomucinosis and Peritoneal Mucinous Carcinomatosis. A Clinicopathologic Analysis of 109 Cases with Emphasis on Distinguishing Pathologic Features, Site of Origin, Prognosis, and Relationship to "pseudomyxoma Peritonei.” The American Journal of Surgical Pathology 19(12): 1390–1408. https://doi.org/10.1097/00000478‐199512000‐00006.
Szych, Christine, Annette Staebler, Denise C Connolly, Rong Wu, Kathleen R. Cho, and Brigitte M. Ronnett. 1999. “Molecular Genetic Evidence Supporting the Clonality and Appendiceal Origin of Pseudomyxoma Peritonei in Women.” The American Journal of Pathology 154(6): 1849–1855. https://doi.org/10.1016/s0002‐9440(10)65442‐9.
Ballentine, Samuel J, Jacquelyn Carr, Eliahu Y Bekhor, Umut Sarpel, and Alexandros D. Polydorides. 2021. “Updated Staging and Patient Outcomes in Low‐Grade Appendiceal Mucinous Neoplasms.” Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc 34(1): 104–115. https://doi.org/10.1038/s41379‐020‐0628‐7.
Van de Moortele, M, G De Hertogh, X Sagaert, et al. 2020. “Appendiceal Cancer: a Review of the Literature.” Acta gastro‐enterologica Belgica 83: 441–448.
Blaj, Sebastian, David Dora, Zoltan Lohinai, Zoltan Herold, Attila Marcell Szasz, Jonas Herzberg, Roland Kodacsi, et al. 2023. “Prognostic Factors in Pseudomyxoma Peritonei with Emphasis on the Predictive Role of Peritoneal Cancer Index and Tumor Markers.” Cancers 15(4): 1326. https://doi.org/10.3390/cancers15041326.
Yan, Tristan D, Lana Bijelic, and Paul H Sugarbaker. 2007. “Critical Analysis of Treatment Failure after Complete Cytoreductive Surgery and Perioperative Intraperitoneal Chemotherapy for Peritoneal Dissemination from Appendiceal Mucinous Neoplasms.” Annals of Surgical Oncology 14(8): 2289–2299. https://doi.org/10.1245/s10434‐007‐9462‐0.
Lopez‐Ramirez, Felipe, Vadim Gushchin, Michelle Sittig, Mary Caitlin King, Ekaterina Baron, Andrei Nikiforchin, Carol Nieroda, and Armando Sardi. 2022. “Iterative Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy for Recurrent Mucinous Adenocarcinoma of the Appendix.” Annals of Surgical Oncology 29(6): 3390–3401. https://doi.org/10.1245/s10434‐021‐11233‐1.
Jordá, Enrique García. 2011. “Survival.” Clinical and Translational Oncology: Official Publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico 13(1): 3–4. https://doi.org/10.1007/s12094‐011‐0609‐x.
Bolliger, M, JA Kroehnert, F Molineus, D. Kandioler, M. Schindl, and P. Riss. 2018. “Experiences with the Standardized Classification of Surgical Complications (Clavien‐Dindo) in General Surgery Patients.” European Surgery : ACA : Acta chirurgica Austriaca 50(6): 256–261. https://doi.org/10.1007/s10353‐018‐0551‐z.
Hoehn, Richard S, Caroline J Rieser, M Haroon Choudry, Nelya Melnitchouk, Jaclyn Hechtman, and Nathan Bahary. 2021. “Current Management of Appendiceal Neoplasms.” American Society of Clinical Oncology educational book American Society of Clinical Oncology Annual Meeting 41: 1–15. https://doi.org/10.1200/edbk_321009.
Youssef, Haney, Christopher Newman, Kandiah Chandrakumaran, Faheez Mohamed, Tom D. Cecil, and Brendan J. Moran. 2011. “Operative Findings, Early Complications, and Long‐Term Survival in 456 Patients with Pseudomyxoma Peritonei Syndrome of Appendiceal Origin.” Diseases of the Colon & Rectum 54(3): 293–299. https://doi.org/10.1007/dcr.0b013e318202f026.
Carr, Norman J, Jenny Finch, Ian Charles Ilesley, Kandiah Chandrakumaran, Faheez Mohamed, Alex Mirnezami, Tom Cecil, and Brendan Moran. 2012. “Pathology and Prognosis in Pseudomyxoma Peritonei: a Review of 274 Cases.” Journal of Clinical Pathology 65(10): 919–923. https://doi.org/10.1136/jclinpath‐2012‐200843.
González‐Moreno, S, and PH Sugarbaker. 2004. “Right Hemicolectomy Does Not Confer a Survival Advantage in Patients with Mucinous Carcinoma of the Appendix and Peritoneal Seeding.” British Journal of Surgery 91(3): 304–311. https://doi.org/10.1002/bjs.4393.
Yu, X.‐Rong, Jun Mao, Wei Tang, X.‐ying Meng, Ye Tian, and Z.‐Li Du. 2020. “Low‐grade Appendiceal Mucinous Neoplasms Confined to the Appendix: Clinical Manifestations and CT Findings.” Journal of Investigative Medicine : The Official Publication of the American Federation for Clinical Research 68(1): 75–81. https://doi.org/10.1136/jim‐2018‐000975.
Faure, M, R Salgado, B Op de Beeck, P Bellinck, Jl Termote, and P M Parizel. 2014. “Mucocele of the Appendix: Case Report and Review of Literature.” Journal of the Belgian Society of Radiology 97(4): 217–221. https://doi.org/10.5334/jbr‐btr.87.
Vaira, Marco, Manuela Robella, Marcello Guaglio, Paola Berchialla, Antonio Sommariva, Mario Valle, Enrico Maria Pasqual, et al. 2023. “Diagnostic and Therapeutic Algorithm for Appendiceal Tumors and Pseudomyxoma Peritonei: A Consensus of the Peritoneal Malignancies Oncoteam of the Italian Society of Surgical Oncology (SICO).” Cancers 15(3): 728. https://doi.org/10.3390/cancers15030728.
Murphy, E M A, SM Farquharson, and BJ Moran. 2006. “Management of an Unexpected Appendiceal Neoplasm.” British Journal of Surgery 93(7): 783–792. https://doi.org/10.1002/bjs.5385.
Panarelli, Nicole C, and Rhonda K Yantiss. 2011. “Mucinous Neoplasms of the Appendix and Peritoneum.” Archives of Pathology & Laboratory Medicine 135(10): 1261–1268. https://doi.org/10.5858/arpa.2011‐0034‐ra.
Rosenberger, Laura H, Louis H Stein, Agnieszka K Witkiewicz, Eugene P. Kennedy, and Charles J. Yeo. 2012. “Intraductal Papillary Mucinous Neoplasm (IPMN) with Extra‐pancreatic Mucin: a Case Series and Review of the Literature.” Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract 16(4): 762–770. https://doi.org/10.1007/s11605‐012‐1823‐8.
Lu, Z, and J Chen. 2014. “[Introduction of WHO Classification of Tumours of Female Reproductive Organs, Fourth Edition].” Zhonghua bing li xue za zhi = Chinese journal of pathology: 649–650.43.
Agrawal, AK, P Bobiński, Z Grzebieniak, J. Rudnicki, G. Marek, P. Kobielak, M. Kazanowski, S. Agrawal, and A. Hałoń. 2014. “Pseudomyxoma Peritonei Originating from Urachus‐Case Report and Review of the Literature.” Current Oncology 21(1): e155–e165. https://doi.org/10.3747/co.21.1695.
Misdraji, Joseph, Rhonda K Yantiss, Fiona M Graeme‐Cook, Ulysses J. Balis, and Robert H. Young. 2003. “Appendiceal Mucinous Neoplasms: a Clinicopathologic Analysis of 107 Cases.” The American Journal of Surgical Pathology 27(8): 1089–1103. https://doi.org/10.1097/00000478‐200308000‐00006.
Pai, Reetesh K, Andrew H Beck, Jeffrey A Norton, and Teri A. Longacre. 2009. “Appendiceal Mucinous Neoplasms: Clinicopathologic Study of 116 Cases with Analysis of Factors Predicting Recurrence.” The American Journal of Surgical Pathology 33(10): 1425–1439. https://doi.org/10.1097/pas.0b013e3181af6067.
Bradley, Robert F, John H Stewart, Gregory B Russell, Edward A. Levine, and Kim R. Geisinger. 2006. “Pseudomyxoma Peritonei of Appendiceal Origin: a Clinicopathologic Analysis of 101 Patients Uniformly Treated at a Single Institution, with Literature Review.” The American Journal of Surgical Pathology 30(5): 551–559. https://doi.org/10.1097/01.pas.0000202039.74837.7d.
Guaglio, Marcello, Snita Sinukumar, Shigeki Kusamura, Massimo Milione, Filippo Pietrantonio, Luigi Battaglia, Stefano Guadagni, Dario Baratti, and Marcello Deraco. 2018. “Clinical Surveillance after Macroscopically Complete Surgery for Low‐Grade Appendiceal Mucinous Neoplasms (LAMN) with or without Limited Peritoneal Spread: Long‐Term Results in a Prospective Series.” Annals of Surgical Oncology 25(4): 878–884. https://doi.org/10.1245/s10434‐017‐6305‐5.
Choudry, Haroon A, Reetesh K Pai, Yongli Shuai, Lekshmi Ramalingam, Heather L. Jones, James F. Pingpank, Steven S. Ahrendt, et al. 2018. “Impact of Cellularity on Oncologic Outcomes Following Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemoperfusion for Pseudomyxoma Peritonei.” Annals of Surgical Oncology 25(1): 76–82. https://doi.org/10.1245/s10434‐017‐6214‐7.
Sugarbaker, Paul H. 2006. “New Standard of Care for Appendiceal Epithelial Neoplasms and Pseudomyxoma Peritonei Syndrome?” The Lancet Oncology 7(1): 69–76. https://doi.org/10.1016/s1470‐2045(05)70539‐8.
Chua, Terence C, Brendan J Moran, Paul H Sugarbaker, Edward A. Levine, Olivier Glehen, François N. Gilly, Dario Baratti, et al. 2012. “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.” Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology 30(20): 2449–2456. https://doi.org/10.1200/jco.2011.39.7166.
Nagtegaal, Iris D, Robert D Odze, David Klimstra, Valerie Paradis, Massimo Rugge, Peter Schirmacher, Kay M Washington, Fatima Carneiro, and Ian A Cree. 2020. “The 2019 WHO Classification of Tumours of the Digestive System.” Histopathology 76(2): 182–188. https://doi.org/10.1111/his.13975.