[A long-term survival case in advanced mucinous cystadenocarcinoma of the appendix using cytoreductive surgery and S-1/CDDP chemotherapy].
Prognosis of patients with advanced mucinous cystadenocarcinoma of the appendix (AMCA) is extremely poor. However, there has been no established treatment strategy. We preliminary report here a successfully treated case with AMCA using intensive cytoreductive surgery and chemotherapy. A 61-year-old woman had a right lower abdominal pain and was diagnosed as acute appendicitis. At surgery, about 5 cm tumor with mucosal fluid was detected at the distal part of the appendix. The tumor was invading the ileum and bladder. We performed appendectomy with tumor, partial resection of the small intestine and debridement of mucosal fluid. Histopathology revealed AMCA invading the ileum and bladder. After non curative surgery, we started S-1 plus cisplatin chemotherapy, which S-1 was given orally, twice daily for 3 consecutive weeks, and cisplatin was given intravenously on day 1, 8 and 15 followed by a 3-week rest period. After 6 courses starting with chemotherapy, a complete response was obtained. We followed by S-1 until two years after the initial surgery. At 36 months after the initial surgery, CT scan demonstrated a peritoneal recurrence. Then, she underwent intensive peritonectomy with intraperitoneal hyperthermic chemotherapy. Currently, she had no apparent recurrence for 59 months after initial surgery.
Dept. of Surgery, Hoyu Hospital.
Shoji
S
Hirajima
Shuhei
S
Komatsu
Tetsuo
T
Adachi
Akira
A
Sakuyama
Yoshizumi
Y
Habuchi
Eigo
E
Otsuj
Masanobu
M
Fukushima
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001065:Appendix / Q000473:pathology*; D002945:Cisplatin / Q000008:administration & dosage / Q000627:therapeutic use*; D003110:Colonic Neoplasms / Q000473:pathology / Q000628:therapy*; D018282:Cystadenocarcinoma, Mucinous / Q000473:pathology / Q000628:therapy*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D008875:Middle Aged; D010094:Oxonic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D012074:Remission Induction; D005641:Tegafur / Q000008:administration & dosage / Q000627:therapeutic use*; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D002945:Cisplatin