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. 1995 Feb;221(2):124–132. doi: 10.1097/00000658-199502000-00002

Prognostic features of 51 colorectal and 130 appendiceal cancer patients with peritoneal carcinomatosis treated by cytoreductive surgery and intraperitoneal chemotherapy.

P H Sugarbaker 1, K A Jablonski 1
PMCID: PMC1234945  PMID: 7857141

Abstract

OBJECTIVE: A treatment plan to be used in patients with peritoneal carcinomatosis was devised and tested as a Phase II study. BACKGROUND: Peritoneal carcinomatosis from appendical or colorectal cancer has been regarded as a fatal clinical entity. Treatment protocols have not been reported previously. METHODS: The authors used cytoreductive surgery and intraperitoneal chemotherapy to treat 181 consecutive patients with peritoneal carcinomatosis. There were 51 patients with colorectal cancer and 130 patients with appendiceal cancer. Mean follow-up is 24 months, with a range of 0 to 149 months. RESULTS: Clinical features that showed prognostic significance included appendiceal versus colorectal primary tumors (p = 0.0001), grade 1 versus grades 2 and 3 histopathology (p = 0.0003), complete versus incomplete cytoreductions (p = 0.0001), lymph node-negative versus lymph node-positive primary tumors (p = 0.0001), and volume of peritoneal carcinomatosis present preoperatively for colon cancer (p = 0.0006). Features with no statistical prognostic significance included preoperative tumor volume for appendiceal cancer, age, sex, number of cycles of chemotherapy, operative time, complications, blood loss, and institution providing treatment. From these prognostic features, four prognostic groups were identified, and 3-year survival was estimated by the product-limit survival method. Group I patients (n = 76) were those with grade 1 histology, no lymph node metastases, and complete cytoreductions (survival at 3 years = 99%). Group II patients (n = 23) were those with grade 2 or 3 histology, no lymph node metastases, and complete cytoreductions (65%). Group III patients (n = 24) had any histology, lymph node metastases, and complete cytoreductions (66%). Group IV patients (n = 58) had incomplete cytoreductions (20%).

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Selected References

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  1. Cohen A. M., Tremiterra S., Candela F., Thaler H. T., Sigurdson E. R. Prognosis of node-positive colon cancer. Cancer. 1991 Apr 1;67(7):1859–1861. doi: 10.1002/1097-0142(19910401)67:7<1859::aid-cncr2820670707>3.0.co;2-a. [DOI] [PubMed] [Google Scholar]
  2. Hughes K. S., Simon R., Songhorabodi S., Adson M. A., Ilstrup D. M., Fortner J. G., Maclean B. J., Foster J. H., Daly J. M., Fitzherbert D. Resection of the liver for colorectal carcinoma metastases: a multi-institutional study of patterns of recurrence. Surgery. 1986 Aug;100(2):278–284. [PubMed] [Google Scholar]
  3. Landen S., Bertrand C., Maddern G. J., Herman D., Pourbaix A., de Neve A., Schmitz A. Appendiceal mucoceles and pseudomyxoma peritonei. Surg Gynecol Obstet. 1992 Nov;175(5):401–404. [PubMed] [Google Scholar]
  4. Scheele J., Stangl R., Altendorf-Hofmann A., Gall F. P. Indicators of prognosis after hepatic resection for colorectal secondaries. Surgery. 1991 Jul;110(1):13–29. [PubMed] [Google Scholar]
  5. Shida H., Ban K., Matsumoto M., Masuda K., Imanari T., Machida T., Yamamoto T. Prognostic significance of location of lymph node metastases in colorectal cancer. Dis Colon Rectum. 1992 Nov;35(11):1046–1050. doi: 10.1007/BF02252994. [DOI] [PubMed] [Google Scholar]
  6. Smith J. W., Kemeny N., Caldwell C., Banner P., Sigurdson E., Huvos A. Pseudomyxoma peritonei of appendiceal origin. The Memorial Sloan-Kettering Cancer Center experience. Cancer. 1992 Jul 15;70(2):396–401. doi: 10.1002/1097-0142(19920715)70:2<396::aid-cncr2820700205>3.0.co;2-a. [DOI] [PubMed] [Google Scholar]
  7. Sugarbaker P. H., Graves T., DeBruijn E. A., Cunliffe W. J., Mullins R. E., Hull W. E., Oliff L., Schlag P. Early postoperative intraperitoneal chemotherapy as an adjuvant therapy to surgery for peritoneal carcinomatosis from gastrointestinal cancer: pharmacological studies. Cancer Res. 1990 Sep 15;50(18):5790–5794. [PubMed] [Google Scholar]
  8. Sugarbaker P. H., Kern K., Lack E. Malignant pseudomyxoma peritonei of colonic origin. Natural history and presentation of a curative approach to treatment. Dis Colon Rectum. 1987 Oct;30(10):772–779. doi: 10.1007/BF02554625. [DOI] [PubMed] [Google Scholar]
  9. Sugarbaker P. H. Peritonectomy procedures. Ann Surg. 1995 Jan;221(1):29–42. doi: 10.1097/00000658-199501000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Sugarbaker P. H. Surgical treatment of peritoneal carcinomatosis: 1988 Du Pont lecture. Can J Surg. 1989 May;32(3):164–170. [PubMed] [Google Scholar]
  11. Sugarbaker P. H., Zhu B. W., Sese G. B., Shmookler B. Peritoneal carcinomatosis from appendiceal cancer: results in 69 patients treated by cytoreductive surgery and intraperitoneal chemotherapy. Dis Colon Rectum. 1993 Apr;36(4):323–329. doi: 10.1007/BF02053933. [DOI] [PubMed] [Google Scholar]
  12. Symonds D. A., Vickery A. L. Mucinous carcinoma of the colon and rectum. Cancer. 1976 Apr;37(4):1891–1900. doi: 10.1002/1097-0142(197604)37:4<1891::aid-cncr2820370439>3.0.co;2-z. [DOI] [PubMed] [Google Scholar]

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