Two-step cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for pseudomyxoma peritonei with high peritoneal carcinomatosis index
| Autor: | Raphael Hamad, Jean-Francois Tremblay, Alexandre Brind’Amour, Pierre Dubé, Bertrand Trilling, Lucas Sideris, Andrew Mitchell |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
lcsh:Surgery Hyperthermic Intraperitoneal Chemotherapy lcsh:RC254-282 03 medical and health sciences 0302 clinical medicine Surgical oncology medicine Pseudomyxoma peritonei Peritoneal Carcinomatosis Index Humans Peritoneal Neoplasms Retrospective Studies Two stage complete cytoreductive surgery Peritoneal metastasis resectability business.industry Research Cytoreduction Surgical Procedures Hyperthermia Induced lcsh:RD1-811 medicine.disease Prognosis Pseudomyxoma Peritonei lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens Combined Modality Therapy Appendix Surgery Omentectomy medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Conventional PCI 030211 gastroenterology & hepatology Hyperthermic intraperitoneal chemotherapy High peritoneal carcinomatosis index Bulky pseudomyxoma business Cytoreductive surgery |
| Zdroj: | World Journal of Surgical Oncology, Vol 19, Iss 1, Pp 1-7 (2021) World Journal of Surgical Oncology |
| ISSN: | 1477-7819 |
| Popis: | BackgroundComplete cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is the only curative treatment for pseudomyxoma peritonei (PMP) arising from the appendix. High peritoneal carcinomatosis index (PCI) is associated with an increased risk of surgical complications. The objective of this study was to present the results of a planned two-step surgical strategy to decrease postoperative morbidity and improve resectability of patients with very high PCI.MethodsAll consecutive patients who underwent a planned two-step surgical approach for PMP between January 2012 and March 2020 were retrospectively included. This approach was offered for patients with low-grade PMP with PCI > 28 for which feasibility of a complete CRS in one operation was uncertain. The first surgery included a complete CRS of the inframesocolic compartment and omentectomy. HIPEC was delivered at the second surgery, after complete CRS of the supramesocolic compartment. Postoperative morbidity was assessed using the Clavien-Dindo classification and survival results were also collected.ResultsEight patients underwent the two-step approach. The median PCI was 33 (29–39) and the median time between the two procedures was 111 days (90–212 days). One patient was deemed unresectable at the second surgery. The rate of major morbidity was 0% for the first step and 25% for the second step, with no mortality. Median follow-up was 53.8 months (3–73 months).ConclusionA two-step surgical management for low-grade PMP patients with very high PCI is safe and feasible, with acceptable postoperative morbidity and no compromise on oncological outcomes. |
| Databáze: | OpenAIRE |
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