Cytoreductive Surgery With or Without Intraperitoneal Chemotherapy for Peritoneal Spread from Appendiceal Neoplasms...

Area of Science:

• Oncology
• Surgical Oncology
• Gastrointestinal Oncology

Background:

• Appendiceal neoplasms can spread to the peritoneum, requiring aggressive treatment.
• Cytoreductive surgery (CRS) and intraperitoneal chemotherapy are established treatments for peritoneal carcinomatosis.
• Outcomes of CRS with or without chemotherapy for appendiceal tumors with peritoneal spread require further evaluation.

Purpose of the Study:

• To assess and compare outcomes after CRS, with or without intraperitoneal chemotherapy.
• To evaluate survival and survival-influencing factors in patients with appendiceal neoplasms and malignancies.
• To determine the efficacy of CRS and intraperitoneal chemotherapy in managing peritoneal metastases from appendiceal tumors.

Main Methods:

• Retrospective analysis of prospectively collected data from 47 patients with appendiceal tumors and peritoneal metastases.
• Treatment involved CRS with or without intraperitoneal chemotherapy.
• Survival analysis included overall survival, completeness of cytoreduction (CCR) grades, subgroup outcomes, and survival-influencing factors.

Main Results:

• The 5-year survival rate was higher for appendiceal neoplasms (50%) than appendiceal cancer (21.6%).
• Higher mortality risk was observed in patients with CCR grades 2-3 (6.7-fold) and appendiceal cancer (8-fold) compared to low-grade neoplasms.
• Postoperative chemotherapy was associated with a significant 74.6% risk reduction in mortality.

Conclusions:

• Peritoneal metastases from appendiceal tumors, especially pseudomyxoma peritonei from low-grade mucinous neoplasms, have acceptable oncologic outcomes with CRS and intraperitoneal chemotherapy.
• CRS should be performed when complete cytoreduction is achievable.
• Aggressive treatment approaches, including CRS and intraperitoneal chemotherapy, are recommended for appendiceal tumors with peritoneal spread.