Critical Analysis of Treatment Failure After Complete Cytoreductive Surgery and Perioperative Intraperitoneal Chemotherapy for Peritoneal Dissemination From Appendiceal Mucinous Neoplasms

Abstract

The present study reported the patterns of treatment failure after complete cytoreduction and demonstrated that a disease-free state is important for long-term survival in peritoneal dissemination from appendiceal mucinous neoplasms. Repeat complete cytoreduction should be pursued when possible and is associated with improved overall survival in patients with recurrent disease.

FOLFOX-4 Chemotherapy for Patients With Unresectable or Relapsed Peritoneal Pseudomyxoma

“…It has been clearly demonstrated that a combined approach of CRS and HIPEC is the standard treatment of patients with PPM because it is able to provide a survival advantage compared with historical controls. Treatment failure may be predicted by several prognostic factors, which were validated in large series [6,[16][17][18]. Several retrospective analyses documented that previous use of systemic chemotherapy was an independent poor prognostic factor for patients undergoing curative CRS and HIPEC for appendiceal neoplasms associated with PPM [19][20][21].…”

Circumferential cutaneous traction for exposure of the layers of the abdominal wall

“…In some patients the cancer remains confined to the abdomen and pelvis throughout the natural history, consequently multiple reoperations can result in benefit [2,3]. Also, more often than not, these patients may come to a definitive surgical intervention having had several prior unsuccessful debulking procedures.…”

Evolution of management in peritoneal surface malignancies

“…Extent of the prior surgeries, high peritoneal cancer index (PCI) (31), elevated levels of CA19-9 (32) and CEA (33) were identified as poor prognostic factors by multivariate analysis. Peritoneal recurrence of PMP occurs as a result of the advanced stage of the disease at the time of initial diagnosis or as the consequence of relative chemoresistance to chemotherapy.…”