Peritonectomy and Intraperitoneal Hyperthermic Perfusion (IPHP): A Strategy That Has Confirmed its Efficacy in Patients with Pseudomyxoma Peritonei

Deraco, Marcello; Baratti, Dario; Inglese, Maria Grazia; Allaria, Biagino; Andreola, Salvatore; Gavazzi, Cecilia; Kusamura, Shigeki

doi:10.1245/aso.2004.07.002

Cited by 148 publications

(85 citation statements)

References 24 publications

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“…In other published series recurrence or progression rates of 40-70% have been reported. 6,7,15 As in other series, we observed that pathological subtype and result of initial cytoreduction were the dominant factors related to progression. 3,10,17 The diagnosis of progressive disease is not always easy.…”

Section: Discussionsupporting

confidence: 80%

“…A number of series using this approach has now been published, showing indeed that longterm disease free and progression free survival can be improved. [3][4][5][6]15,16 Still, even after this combined modality treatment progression was observed in our series in 41% of cases. In other published series recurrence or progression rates of 40-70% have been reported.…”

Section: Discussionsupporting

confidence: 42%

“…HIPEC seems to reduce the recurrence or progression rate significantly by the cytotoxic effect on (microscopic) tumor residue, especially in patients with low-grade pathology and complete cytoreduction. 3,[5][6][7] Recurrent or progressive disease after this combined modality treatment is however, still a problem. Treatment approaches for recurrent or progressive PMP are not well described, although surgery seems to be the most common option.…”

mentioning

confidence: 99%

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Progression of Pseudomyxoma Peritonei after Combined Modality Treatment: Management and Outcome

et al. 2006

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Background: Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is a treatment strategy for pseudomyxoma peritonei (PMP) with curative intent. The aim of this study was to determine the patterns of failure in patients who underwent such a procedure and to evaluate management and outcome of progressive disease.Methods: After exclusion of patients with overt malignancy, progression was studied in 96 PMP patients treated primarily by CRS with HIPEC. Location, pathology, management and outcome were recorded.Results: Median follow-up was 51.5 months (0.1-99.5). Median progression free survival (PFS) was 28.2 months (95% CI 18.3->). Progressive disease was mainly located sub hepatic (38%) or in multiple regions (36%). Pathological dedifferentiation was observed in 8 patients (20%). The choice of treatment depended on pathology, extent of disease and PFS. Seventeen patients were treated for progression by second CRS with (n=8) or without HIPEC (n=10). The 3-years overall survival (OS) probability after this treatment was 100% and 53.3% (95% CI 28.2-100%), respectively. Fifteen patients with (slow) progression were observed. Threeyears OS probability of these patients was 66.0% (95% CI 43.4-100%). All patients treated for progression by systemic chemotherapy only (n=6) had died of disease after a median follow up of 14.8 (9.8-33.6) months. A longer PFS after primary treatment was associated with longer OS after progression (P = 0.04).Conclusions: Progressive PMP after primary CRS with HIPEC is probably the result of technical failure and/or tumor biology. Management of progressive PMP can be valuable for selected patients and should depend primarily on the PFS.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionsupporting

confidence: 42%

mentioning

confidence: 99%

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Progression of Pseudomyxoma Peritonei after Combined Modality Treatment: Management and Outcome

et al. 2006

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“…Many studies show 5-year overall survival rates that are improved with cytoreductive surgery and HIPEC, when compared to cytoreductive surgery alone, 53-100% versus 53-75%, respectively [7,9,15,17,19,[21][22][23][26][27][28][29][30][31]. Despite these results, there have been no randomized controlled trials comparing cytoreductive surgery and cytoreductive surgery with HIPEC in patients with low-grade appendiceal neoplasms.…”

Section: Resultsmentioning

confidence: 99%

“…All these studies suggest improved survival in those with low-grade disease, but whether or not the addition of HIPEC also plays a role is difficult to know without randomized control trials. Although we see a potential benefit with the use of HIPEC in selected patients, the risks and benefits of using this need to be adjusted for Deraco et al conducted a phase II study by evaluating cytoreductive surgery and HIPEC using Mitomycin-C and Cisplatin [22]. They had 33 patients with pseudomyxoma peritonei, the majority of which had DPAM.…”

Section: Journal Of Gastrointestinal and Digestive Systemmentioning

confidence: 99%

The Role of Heated Intraperitoneal Chemotherapy (HIPEC) in Low-Grade Appendiceal Neoplasm: Friend or Foe?

Porpiglia¹,

Nguyen²,

Farma³

et al. 2016

J Gastrointest Dig Syst

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Low-grade mucinous appendiceal neoplasms are rare tumors. There is limited data on the treatment for pseudomyxoma peritonei with low-grade appendiceal histology. Classifications of appendiceal neoplasms include low-grade appendiceal mucinous neoplasm (LAMN), diffuse peritoneal adenomucinosis (DPAM), and peritoneal mucinous carcinomatosis (PMCA). Studies have demonstrated patients with low-grade appendiceal neoplasms have improved overall survival compared to patients with high-grade appendiceal neoplasms. Since low-grade tumors have better prognosis some retrospective trials have suggested observation in patients with these types of tumors. Another option includes cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). We have done an extensive literature search exploring the various methods in which to treat patients with this disease.

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Sugarbaker procedure for pseudomyxoma peritonei

Nigam

Renehan

Saunders

et al. 2006

Cochrane Database of Systematic Reviews

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Peritonectomy and Intraperitoneal Hyperthermic Perfusion (IPHP): A Strategy That Has Confirmed its Efficacy in Patients with Pseudomyxoma Peritonei

Abstract: CRS associated with IPHP permitted complete tumor removal with an acceptable morbidity and mortality for patients with PMP. This study confirms the efficacy of the combined treatment in terms of long-term survival and local disease control.

Cited by 148 publications

References 24 publications

Progression of Pseudomyxoma Peritonei after Combined Modality Treatment: Management and Outcome

Progression of Pseudomyxoma Peritonei after Combined Modality Treatment: Management and Outcome

The Role of Heated Intraperitoneal Chemotherapy (HIPEC) in Low-Grade Appendiceal Neoplasm: Friend or Foe?

Sugarbaker procedure for pseudomyxoma peritonei

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