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Secondary organs, including lymph nodes, the spleen, and mucosa-associated lymphoid tissue (MALT), work harmoniously to protect us from disease and infection.
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Culture and Imaging of Ex Vivo Organotypic Pseudomyxoma Peritonei Tumor Slices from Resected Human Tumor Specimens
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Lymph node positive pseudomyxoma peritonei.

Paul H Sugarbaker1, David Chang2

  • 1Program in Peritoneal Surface Malignancy, MedStar Washington Hospital Center, Washington, DC, USA.

European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
|August 8, 2022
PubMed
Summary
This summary is machine-generated.

Appendiceal mucinous neoplasms with lymph node metastases are rare but can lead to long-term survival. Response to neoadjuvant chemotherapy significantly improves outcomes for these patients.

Keywords:
Appendiceal mucinous neoplasmCytoreductive surgeryEPICHIPECMucoceleMutationsNeoadjuvant chemotherapyPeritonectomyTumorigenesis

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Area of Science:

  • Oncology
  • Gastroenterology

Background:

  • Appendiceal mucinous neoplasms frequently present with peritoneal metastases.
  • Liver and lymph node metastases are uncommon at initial diagnosis.

Purpose of the Study:

  • To analyze clinical, treatment, and histological factors impacting survival in patients with appendiceal mucinous neoplasms and lymph node metastases.
  • To identify predictors of outcome in this rare patient cohort.

Main Methods:

  • Statistical analysis of a prospectively maintained database of 685 patients undergoing cytoreduction for appendiceal mucinous neoplasm with peritoneal dissemination.
  • Selection of 39 patients (5.6%) with lymph node metastases for detailed study.
  • Evaluation of treatment variables, including neoadjuvant chemotherapy, cytoreductive surgery (CRS), and hyperthermic intraperitoneal chemotherapy (HIPEC).

Main Results:

  • Median follow-up was 5.0 years, with an overall median survival of 6.0 years.
  • 15.4% of patients had an appendiceal mucinous neoplasm - Intermediate type (MACA-Int).
  • Patients achieving a complete or near-complete response to neoadjuvant chemotherapy (17.9%) demonstrated prolonged survival (HR 4.8, p=0.0323).

Conclusions:

  • Long-term survival is possible, though infrequent, in patients with appendiceal mucinous neoplasms and lymph node metastases.
  • Response to neoadjuvant chemotherapy is a critical factor for favorable outcomes.