Complete pathologic response after two-stage cytoreductive surgery with HIPEC for bulky pseudomyxoma peritonei: proof of concept

International Journal of Hyperthermia

Andrea Petruzziello¹  Frédéric Bibeau²  Rodrigo Figueroa³  Olivia Sgarbura⁴  Marie-Hélène Pissas⁴  Sébastien Carrère⁴  François Quénet⁴  Mohammed Al Hosni⁵  Stephanie Nougaret⁶  Lakhdar Khellaf⁶ 

[1] Marcelino Champagnat Hospital;Pathology Department, Caen University Hospital, University of Caen Normandy;Sanatorio Allende;Surgical Oncology Department, Montpellier Cancer Institute, University of Montpellier;Surgical Oncology Division, Department of Surgery, Sultan Qaboos University Hospital;University of Medicine Montpellier 2 Rue de l’École de Médecine;

关键词: pseudomyxoma peritonei;    cytoreductive surgery;    hyperthermic intraperitoneal chemotherapy;    two-stage surgery;    oxaliplatin;   

DOI  :  10.1080/02656736.2020.1772511

来源: DOAJ

【 摘 要 】

Introduction Pseudomyxoma peritonei (PMP) is a rare disease characterized by the progressive accumulation of mucinous ascites and peritoneal implants. The optimal treatment for PMP includes the association of complete cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). For patients with a large burdensome disease, the completeness of cytoreduction sometimes requires maximal effort surgery. The aim of this article is to provide proof of concept for two stage cytoreductive surgery (CRS) in this category of patients. Methods and materials A two stage CRS and HIPEC with oxaliplatin was proposed for patients with bulky PMP including important involvement of the serosal surfaces of the bowel or colon who had an impaired nutritional status. The residual disease at the end of the first stage was less than 5 mm of thickness on several implants. Clinical, surgical and histopathological variables were analyzed. Results All eight patients completed the two-stage strategy. Mortality was nil. One Clavien Dindo grade 3 event occurred in each stage. After a median follow up of 29.5 months, all patients were alive and free of recurrence. All of the patients had histopathological complete response on the specimens obtained from the residual sites during the second stage surgery. Conclusions Two-stage surgical strategy is feasible for bulky PMP patients and it is associated with little high-grade morbidity and enhanced visceral sparing.

【 授权许可】

Unknown