Retrospective Review of Outcomes in Non-Invasive Mucinous Appendiceal Neoplasms with and without Peritoneal Spread: A Cohort Study
Patients treated surgically for local non-invasive mucinous appendiceal neoplasm (NI-MAN) may recur with the development of peritoneal dissemination (PD). The risk of recurrence and predictive factors are not well studied. Patients with NI-MAN, with or without peritoneal dissemination at presentatio...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-11-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/29/12/714 |
| _version_ | 1797460779201462272 |
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| author | Arkadii Sipok Jonathan M. Dort Anthony Visioni Lana Bijelic |
| author_facet | Arkadii Sipok Jonathan M. Dort Anthony Visioni Lana Bijelic |
| author_sort | Arkadii Sipok |
| collection | DOAJ |
| description | Patients treated surgically for local non-invasive mucinous appendiceal neoplasm (NI-MAN) may recur with the development of peritoneal dissemination (PD). The risk of recurrence and predictive factors are not well studied. Patients with NI-MAN, with or without peritoneal dissemination at presentation, were included. Patients with limited disease underwent surgical resection only. Patients with peritoneal dissemination underwent cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy (HIPEC). Patients without PD (nPD) were compared to those who presented with PD. Thirty-nine patients were included, 25 in nPD and 14 in PD. LAMN was diagnosed in 96% and 93% of patients in nPD and PD, respectively. Acellular mucin on the peritoneal surface was seen in 16% of nPD patients vs. 50% of PD patients (<i>p</i> = 0.019). Two (8%) patients in the nPD group who had LAMN without wall rupture recurred, at 57 and 68 months, with a PCI of 9 and 22. The recurrence rate in the PD group was 36%. All recurred patients underwent CRS+HIPEC. A peritoneal recurrence is possible in NI-MANs confined to the appendix even with an intact wall at initial diagnosis. The peritoneal disease may occur with significant delay, which is longer than a conventional follow-up. |
| first_indexed | 2024-03-09T17:09:55Z |
| format | Article |
| id | doaj.art-fe757c09619a43be9674bda68c99d990 |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-09T17:09:55Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-fe757c09619a43be9674bda68c99d9902023-11-24T14:12:16ZengMDPI AGCurrent Oncology1198-00521718-77292022-11-0129129125913410.3390/curroncol29120714Retrospective Review of Outcomes in Non-Invasive Mucinous Appendiceal Neoplasms with and without Peritoneal Spread: A Cohort StudyArkadii Sipok0Jonathan M. Dort1Anthony Visioni2Lana Bijelic3Department of Surgery, Inova Medical Campus, 3300 Gallows Rd, Falls Church, VA 22042, USADepartment of Surgery, Inova Medical Campus, 3300 Gallows Rd, Falls Church, VA 22042, USADepartment of General Surgery, Cleveland Clinic, Akron General Ave, Akron, OH 44307, USAConsorci Sanitari Integral, Hospital Sant Joan Despì, 90 Moises Broggi Calle Jacint Verdaguer, Sant Joan Despí, 08970 Barcelona, SpainPatients treated surgically for local non-invasive mucinous appendiceal neoplasm (NI-MAN) may recur with the development of peritoneal dissemination (PD). The risk of recurrence and predictive factors are not well studied. Patients with NI-MAN, with or without peritoneal dissemination at presentation, were included. Patients with limited disease underwent surgical resection only. Patients with peritoneal dissemination underwent cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy (HIPEC). Patients without PD (nPD) were compared to those who presented with PD. Thirty-nine patients were included, 25 in nPD and 14 in PD. LAMN was diagnosed in 96% and 93% of patients in nPD and PD, respectively. Acellular mucin on the peritoneal surface was seen in 16% of nPD patients vs. 50% of PD patients (<i>p</i> = 0.019). Two (8%) patients in the nPD group who had LAMN without wall rupture recurred, at 57 and 68 months, with a PCI of 9 and 22. The recurrence rate in the PD group was 36%. All recurred patients underwent CRS+HIPEC. A peritoneal recurrence is possible in NI-MANs confined to the appendix even with an intact wall at initial diagnosis. The peritoneal disease may occur with significant delay, which is longer than a conventional follow-up.https://www.mdpi.com/1718-7729/29/12/714pseudomyxoma peritoneimucinous carcinoma peritoneiperitoneal metastasescytoreductive surgeryheated intraperitoneal chemotherapyappendix |
| spellingShingle | Arkadii Sipok Jonathan M. Dort Anthony Visioni Lana Bijelic Retrospective Review of Outcomes in Non-Invasive Mucinous Appendiceal Neoplasms with and without Peritoneal Spread: A Cohort Study Current Oncology pseudomyxoma peritonei mucinous carcinoma peritonei peritoneal metastases cytoreductive surgery heated intraperitoneal chemotherapy appendix |
| title | Retrospective Review of Outcomes in Non-Invasive Mucinous Appendiceal Neoplasms with and without Peritoneal Spread: A Cohort Study |
| title_full | Retrospective Review of Outcomes in Non-Invasive Mucinous Appendiceal Neoplasms with and without Peritoneal Spread: A Cohort Study |
| title_fullStr | Retrospective Review of Outcomes in Non-Invasive Mucinous Appendiceal Neoplasms with and without Peritoneal Spread: A Cohort Study |
| title_full_unstemmed | Retrospective Review of Outcomes in Non-Invasive Mucinous Appendiceal Neoplasms with and without Peritoneal Spread: A Cohort Study |
| title_short | Retrospective Review of Outcomes in Non-Invasive Mucinous Appendiceal Neoplasms with and without Peritoneal Spread: A Cohort Study |
| title_sort | retrospective review of outcomes in non invasive mucinous appendiceal neoplasms with and without peritoneal spread a cohort study |
| topic | pseudomyxoma peritonei mucinous carcinoma peritonei peritoneal metastases cytoreductive surgery heated intraperitoneal chemotherapy appendix |
| url | https://www.mdpi.com/1718-7729/29/12/714 |
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