Prognostic Factors in Pseudomyxoma Peritonei with Emphasis on the Predictive Role of Peritoneal Cancer Index and Tumor Markers
Background: Pseudomyxoma peritonei (PMP) is a rare peritoneal condition where mucus-secreting tumorous cells progressively produce a thick, gelatin-like substance. The prognosis of patients with PMP is determined by the degree of cellularity within the mucin (low-grade (LAMN) vs. high-grade (HAMN) h...
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| Format: | Article |
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MDPI AG
2023-02-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/4/1326 |
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| author | Sebastian Blaj David Dora Zoltan Lohinai Zoltan Herold Attila Marcell Szasz Jonas Herzberg Roland Kodacsi Saher Baransi Hans Jürgen Schlitt Matthias Hornung Jens M. Werner Przemyslaw Slowik Miklos Acs Pompiliu Piso |
| author_facet | Sebastian Blaj David Dora Zoltan Lohinai Zoltan Herold Attila Marcell Szasz Jonas Herzberg Roland Kodacsi Saher Baransi Hans Jürgen Schlitt Matthias Hornung Jens M. Werner Przemyslaw Slowik Miklos Acs Pompiliu Piso |
| author_sort | Sebastian Blaj |
| collection | DOAJ |
| description | Background: Pseudomyxoma peritonei (PMP) is a rare peritoneal condition where mucus-secreting tumorous cells progressively produce a thick, gelatin-like substance. The prognosis of patients with PMP is determined by the degree of cellularity within the mucin (low-grade (LAMN) vs. high-grade (HAMN) histologic features) and by the extent of the disease. Methods: Prognostic relevance of tumor markers CA19-9 and CEA, gender, Peritoneal Cancer Index (PCI), and completeness of cytoreduction (CC) after cytoreductive surgery were evaluated on 193 consecutive PMP patients, based on a retrospective analysis of prospectively gathered data from a German tertial referral center. Results: We demonstrated that low PCI, CC0 status, low-grade histology, and female gender were independent positive prognostic factors for both overall survival (OS) and progression-free survival (PFS). Furthermore, LAMN patients with achieved CC0 status show significantly better OS and PFS compared to those with CC1 status (<i>p</i> = 0.0353 and <i>p</i> = 0.0026 respectively). In contrast, the duration and drug of hyperthermic intraperitoneal chemotherapy (HIPEC) were not prognostic in any comparison. Increased CA19-9 and CEA levels were significantly associated with HAMN cases, but also predicted recurrence in patients with low-grade histologies. Conclusion: Our study confirmed the prognostic role of tumor markers and emphasized the importance of CC status and PCI in a large cohort of PMP- and LAMN patients. |
| first_indexed | 2024-03-11T09:01:37Z |
| format | Article |
| id | doaj.art-17da043c3fde4807b0e1da7f33093099 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T09:01:37Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-17da043c3fde4807b0e1da7f330930992023-11-16T19:39:27ZengMDPI AGCancers2072-66942023-02-01154132610.3390/cancers15041326Prognostic Factors in Pseudomyxoma Peritonei with Emphasis on the Predictive Role of Peritoneal Cancer Index and Tumor MarkersSebastian Blaj0David Dora1Zoltan Lohinai2Zoltan Herold3Attila Marcell Szasz4Jonas Herzberg5Roland Kodacsi6Saher Baransi7Hans Jürgen Schlitt8Matthias Hornung9Jens M. Werner10Przemyslaw Slowik11Miklos Acs12Pompiliu Piso13Department of General and Visceral Surgery, Hospital Barmherzige Brüder, D-93049 Regensburg, GermanyDepartment of Anatomy, Histology and Embryology, Semmelweis University, H-1094 Budapest, HungaryTranslational Medicine Institute, Semmelweis University, H-1094 Budapest, HungaryDivision of Oncology, Department of Internal Medicine and Oncology, Semmelweis University, H-1083 Budapest, HungaryDivision of Oncology, Department of Internal Medicine and Oncology, Semmelweis University, H-1083 Budapest, HungaryDepartment of Surgery, Krankenhaus Reinbek St. Adolf-Stift, D-21465 Reinbek, GermanyDepartment of Cardiothoracic Surgery, University Medical Center, D-93053 Regensburg, GermanyDepartment of Gynecology and Obstetrics, Florence Nightingale Hospital, D-40489 Düsseldorf, GermanyDepartment of Surgery, University Hospital, 93053 Regensburg, GermanyDepartment of Surgery, University Hospital, 93053 Regensburg, GermanyDepartment of Surgery, University Hospital, 93053 Regensburg, GermanyDepartment of Surgery, University Hospital, 93053 Regensburg, GermanyDepartment of General and Visceral Surgery, Hospital Barmherzige Brüder, D-93049 Regensburg, GermanyDepartment of General and Visceral Surgery, Hospital Barmherzige Brüder, D-93049 Regensburg, GermanyBackground: Pseudomyxoma peritonei (PMP) is a rare peritoneal condition where mucus-secreting tumorous cells progressively produce a thick, gelatin-like substance. The prognosis of patients with PMP is determined by the degree of cellularity within the mucin (low-grade (LAMN) vs. high-grade (HAMN) histologic features) and by the extent of the disease. Methods: Prognostic relevance of tumor markers CA19-9 and CEA, gender, Peritoneal Cancer Index (PCI), and completeness of cytoreduction (CC) after cytoreductive surgery were evaluated on 193 consecutive PMP patients, based on a retrospective analysis of prospectively gathered data from a German tertial referral center. Results: We demonstrated that low PCI, CC0 status, low-grade histology, and female gender were independent positive prognostic factors for both overall survival (OS) and progression-free survival (PFS). Furthermore, LAMN patients with achieved CC0 status show significantly better OS and PFS compared to those with CC1 status (<i>p</i> = 0.0353 and <i>p</i> = 0.0026 respectively). In contrast, the duration and drug of hyperthermic intraperitoneal chemotherapy (HIPEC) were not prognostic in any comparison. Increased CA19-9 and CEA levels were significantly associated with HAMN cases, but also predicted recurrence in patients with low-grade histologies. Conclusion: Our study confirmed the prognostic role of tumor markers and emphasized the importance of CC status and PCI in a large cohort of PMP- and LAMN patients.https://www.mdpi.com/2072-6694/15/4/1326pseudomyxoma peritoneilow-grade appendiceal mucinous neoplasmshyperthermic intraperitoneal chemotherapyperitoneal cancer indexcytoreductive surgerybiomarkers |
| spellingShingle | Sebastian Blaj David Dora Zoltan Lohinai Zoltan Herold Attila Marcell Szasz Jonas Herzberg Roland Kodacsi Saher Baransi Hans Jürgen Schlitt Matthias Hornung Jens M. Werner Przemyslaw Slowik Miklos Acs Pompiliu Piso Prognostic Factors in Pseudomyxoma Peritonei with Emphasis on the Predictive Role of Peritoneal Cancer Index and Tumor Markers Cancers pseudomyxoma peritonei low-grade appendiceal mucinous neoplasms hyperthermic intraperitoneal chemotherapy peritoneal cancer index cytoreductive surgery biomarkers |
| title | Prognostic Factors in Pseudomyxoma Peritonei with Emphasis on the Predictive Role of Peritoneal Cancer Index and Tumor Markers |
| title_full | Prognostic Factors in Pseudomyxoma Peritonei with Emphasis on the Predictive Role of Peritoneal Cancer Index and Tumor Markers |
| title_fullStr | Prognostic Factors in Pseudomyxoma Peritonei with Emphasis on the Predictive Role of Peritoneal Cancer Index and Tumor Markers |
| title_full_unstemmed | Prognostic Factors in Pseudomyxoma Peritonei with Emphasis on the Predictive Role of Peritoneal Cancer Index and Tumor Markers |
| title_short | Prognostic Factors in Pseudomyxoma Peritonei with Emphasis on the Predictive Role of Peritoneal Cancer Index and Tumor Markers |
| title_sort | prognostic factors in pseudomyxoma peritonei with emphasis on the predictive role of peritoneal cancer index and tumor markers |
| topic | pseudomyxoma peritonei low-grade appendiceal mucinous neoplasms hyperthermic intraperitoneal chemotherapy peritoneal cancer index cytoreductive surgery biomarkers |
| url | https://www.mdpi.com/2072-6694/15/4/1326 |
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