title: Systemic chemotherapy (SC) before cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) in patients with peritoneal mucinous carcinomatosis of appendiceal origin (PMCA).
abstract: BACKGROUND
  The role of SC before CRS/HIPEC for patients with PMCA is unclear. This study explores the effect of SC prior to CRS/HIPEC on overall survival (OS) in patients with PMCA.
  
  
  METHODS
  72 patients with recently diagnosed PMCA who underwent CRS/HIPEC were identified from a prospective database. Thirty patients had SC before CRS/HIPEC (Group 1) and 42 did not (Group 2). Patients who were referred to our center after multiple lines of SC were excluded from this analysis. OS was estimated.
  
  
  RESULTS
  Median follow-up was 3.2 years. Groups were similar regarding lymph node positivity, postoperative SC and rate of complete cytoreduction. Twenty-four (80%) patients in Group 1 and 21 (50%) in Group 2 had high grade histology (HG) (p = 0.01). OS from CRS/HIPEC at 1, 2, and 3 years was 93, 68, 51% in Group 1 and 82, 64, 60% in Group 2, respectively (p = 0.74). Among HG patients 3-year survival was 36% in the SC group vs. 35% in the group without SC (p = 0.67). The 3-year OS for patients with low grade (LG) tumors was 100% in the SC group vs. 79% in the group with no prior SC (p = 0.26). Among patients with signet ring cell (SRC) histology, 1, 2 and 3-year survival was 94, 67 and 22% in the SC group vs. 43, 14, 14% in the group with no SC, respectively (p = 0.028). There were only 6 patients with LG PMCA who received prior SC.
  
  
  CONCLUSIONS
  Preoperative SC could improve the prognosis of patients with high-grade PMCA with SRC histology.
authors: Department of Surgical Oncology, Mercy Medical Center, 227 St Paul Place, Baltimore, MD 21202-2001, USA. Electronic address: vmilovan@mdmercy.com.
authors: V
authors: V
authors: Milovanov
authors: Department of Surgical Oncology, Mercy Medical Center, 227 St Paul Place, Baltimore, MD 21202-2001, USA. Electronic address: asardi@mdmercy.com.
authors: A
authors: A
authors: Sardi
authors: Department of Surgical Oncology, Mercy Medical Center, 227 St Paul Place, Baltimore, MD 21202-2001, USA. Electronic address: pledakis@mdmercy.com.
authors: P
authors: P
authors: Ledakis
authors: Department of Surgical Oncology, Mercy Medical Center, 227 St Paul Place, Baltimore, MD 21202-2001, USA. Electronic address: naydin@mdmercy.com.
authors: N
authors: N
authors: Aydin
authors: Department of Surgical Oncology, Mercy Medical Center, 227 St Paul Place, Baltimore, MD 21202-2001, USA. Electronic address: cnieroda@mdmercy.com.
authors: C
authors: C
authors: Nieroda
authors: Department of Surgical Oncology, Mercy Medical Center, 227 St Paul Place, Baltimore, MD 21202-2001, USA. Electronic address: msittig@mdmercy.com.
authors: M
authors: M
authors: Sittig
authors: Department of Surgical Oncology, Mercy Medical Center, 227 St Paul Place, Baltimore, MD 21202-2001, USA. Electronic address: mnunez@mdmercy.com.
authors: M
authors: M
authors: Nunez
authors: Department of Surgical Oncology, Mercy Medical Center, 227 St Paul Place, Baltimore, MD 21202-2001, USA. Electronic address: vgushchin@mdmercy.com.
authors: V
authors: V
authors: Gushchin
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000556:secondary / Q000628:therapy*; D000328:Adult; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001063:Appendiceal Neoplasms / Q000473:pathology*; D000068258:Bevacizumab; D002166:Camptothecin / Q000031:analogs & derivatives / Q000627:therapeutic use; D000069287:Capecitabine; D002276:Carcinoid Tumor / Q000556:secondary / Q000628:therapy*; D018279:Carcinoma, Signet Ring Cell / Q000556:secondary / Q000628:therapy*; D065426:Cytoreduction Surgical Procedures; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D006979:Hyperthermia, Induced; D007263:Infusions, Parenteral; D002955:Leucovorin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000627:therapeutic use; D000077150:Oxaliplatin; D010534:Peritoneal Neoplasms / Q000556:secondary / Q000628:therapy*; D010537:Peritoneum / Q000601:surgery*; D011446:Prospective Studies; D012189:Retrospective Studies
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D003841:Deoxycytidine; D000068258:Bevacizumab; D000069287:Capecitabine; D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin
keywords: Cytoreductive surgery; Hyperthermic intraperitoneal chemotherapy; Mucinous carcinomatosis of appendiceal origin; Systemic chemotherapy