Perioperative systemic chemotherapy for appendiceal mucinous carcinoma peritonei treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.

Abstract

BACKGROUND:

The role of systemic chemotherapy (SC) in conjunction with cytoreductive surgery (CS) with hyperthermic intraperitoneal chemotherapy (HIPEC) in appendiceal mucinous carcinoma peritonei (MCP) is unknown.

METHODS:

A retrospective review (1999-2011) of MCP patients who had undergone CS/HIPEC with or without perioperative SC.

RESULTS:

Twenty-two low-grade MCP patients treated with CS/HIPEC and SC were matched to patients who received CS/HIPEC alone. Median overall survival (OS) was 107 months for patients treated with perioperative SC compared to 72 without (P = 0.46). CS/HIPEC was performed on 109 patients with high-grade MCP: 70 were treated with perioperative SC, while 39 were not. Median OS (22.1 vs. 19.6 months, P = 0.74) and progression-free survival (PFS) (10.9 vs. 7.0 months, P = 0.47) were similar in patients treated with SC compared to CS/HIPEC alone. Progression while on pre-operative SC was seen in eight patients (17%), while four (8%) had a partial response. Treatment with post-operative SC was associated with longer PFS (13.6 months) compared to pre-operative SC (6.8 months, P < 0.01) and CS/HIPEC alone (7.0 months, P = 0.03).

CONCLUSIONS:

Post-operative SC appears to improve PFS in patients with high-grade appendiceal MCP treated with CS/HIPEC. In contrast, there is no evidence to support the routine use of perioperative SC in low-grade disease.

• Authors: Aaron U Blackham, Katrina Swett, Cathy Eng, Joseph Sirintrapun, Simon Bergman, Kim R Geisinger, Konstantinos Votanopoulos, John H Stewart, Perry Shen, Edward A Levine
• Journal: Journal of surgical oncology (J Surg Oncol) Vol. 109 Issue 7 Pg. 740-5 (Jun 2014) ISSN: 1096-9098 [Electronic] United States
• PMID: 24375188 (Publication Type: Journal Article)
• Copyright: © 2013 Wiley Periodicals, Inc.

Topics

• Antineoplastic Combined Chemotherapy Protocols (administration & dosage)
• Appendiceal Neoplasms (mortality, therapy)
• Combined Modality Therapy
• Female
• Humans
• Hyperthermia, Induced
• Infusions, Parenteral
• Male
• Middle Aged
• Peritoneal Neoplasms (mortality, therapy)
• Pseudomyxoma Peritonei (mortality, therapy)
• Retrospective Studies