Perioperative systemic chemotherapy for appendiceal mucinous carcinoma peritonei treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Issue 7 (28th December 2013)

• Record Type: Journal Article
• Authors: Blackham, Aaron U.; Swett, Katrina; Eng, Cathy; Sirintrapun, Joseph; Bergman, Simon; Geisinger, Kim R; Votanopoulos, Konstantinos; Stewart, John H.; Shen, Perry; Levine, Edward A.
• Is Part Of: Journal of surgical oncology. Volume 109:Issue 7(2014:Jun. 01)
• Page Start: 740
• Page End: 745
• Publication Date: 2013-12-28
• Subjects: Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.23547
• Languages: English
• ISSNs: 0022-4790

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jso23547-sec-0001" sec-type="section"> <title>Background</title> <p>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.</p> </sec> <sec id="jso23547-sec-0002" sec-type="section"> <title>Methods</title> <p>A retrospective review (1999–2011) of MCP patients who had undergone CS/HIPEC with or without perioperative SC.</p> </sec> <sec id="jso23547-sec-0003" sec-type="section"> <title>Results</title> <p>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 (<italic>P</italic> = 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, <italic>P</italic> = 0.74) and progression‐free survival (PFS) (10.9 vs. 7.0 months, <italic>P</italic> = 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, <italic>P</italic> < 0.01) and CS/HIPEC alone (7.0 months, <italic>P</italic> = 0.03).</p> </sec> <sec id="jso23547-sec-0004" sec-type="section"> <title>Conclusions</title> <p>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. <italic>J. Surg. Oncol 2014; 109:740–745</italic>. © 2013 Wiley Periodicals, Inc.</p> </sec> </abstract>