Long-term outcomes for patients with peritoneal acellular mucinosis secondary to low grade appendiceal mucinous neoplasms.

T Evans, O Aziz, B Chakrabarty, M S Wilson, L Malcomson, C Lavelle, S T O'Dwyer
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引用次数: 10

Abstract

Introduction: Low grade appendiceal mucinous neoplasms (LAMN) are known to metastasise to the peritoneum resulting in pseudomyxoma peritonei (PMP). Literature suggests that the long-term outcome is dependent on the cellular grade of the peritoneal histology, less is known about the risk to patients with acellular mucinosis (AM) alone. This study aims to review long-term outcomes in patients with PMP treated with Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (CRS/HIPEC), whose peritoneal histology was AM secondary to LAMN.

Methods: Pathological and treatment outcomes were collected from a prospectively maintained database between 2005 and 2019. Data was collected on patients with LAMN and AM diagnosed following CRS/HIPEC. A single institution performed the surgery and pathology reporting, samples reported by three different pathologists.

Results: Of the 2079 patients with any appendiceal neoplasm referred between 2005 and 2019, 809 underwent CRS/HIPEC, 67 (8%) of those had PMP with purely AM secondary to a LAMN. In the AM group the median age was 59, 37 (55%) were female, follow up was for a median 39 (2-145) months. Inpatient mortality occurred in 1 patient (1.5%), disease specific mortality in 2 (3%), recurrence in 2 (3%) and disease progression in 1 (1.5%).

Conclusion: This study has identified AM secondary to LAMN as a low risk group for recurrence following CRS/HIPEC compared with epithelial pathology. Given such a low rate of recurrence we would recommend low intensity surveillance post CRS/HIPEC. Agreed standardised pathological assessment is required to exclude cellular material in specimens and diagnose AM.

低度阑尾黏液性肿瘤继发的腹膜脱细胞黏液病患者的长期预后。
简介:低级别阑尾黏液性肿瘤(LAMN)转移到腹膜导致腹膜假性黏液瘤(PMP)。文献表明,长期预后依赖于腹膜组织学的细胞分级,对于单纯无细胞黏液病(AM)患者的风险知之甚少。本研究旨在回顾经细胞减少手术和腹腔高温化疗(CRS/HIPEC)治疗的腹膜组织学为AM继发于LAMN的PMP患者的长期预后。方法:从2005年至2019年前瞻性维护的数据库中收集病理和治疗结果。收集CRS/HIPEC诊断的LAMN和AM患者的数据。一个机构进行手术和病理报告,样本由三个不同的病理学家报告。结果:在2005年至2019年期间转诊的2079例阑尾肿瘤患者中,809例接受了CRS/HIPEC,其中67例(8%)患有单纯AM继发于LAMN的PMP。AM组中位年龄59岁,女性37例(55%),随访中位39(2-145)个月。住院死亡1例(1.5%),疾病特异性死亡2例(3%),复发2例(3%),疾病进展1例(1.5%)。结论:本研究发现,与上皮病理相比,继发于LAMN的AM是CRS/HIPEC后复发的低风险组。鉴于如此低的复发率,我们建议在CRS/HIPEC后进行低强度监测。需要商定的标准化病理评估来排除标本中的细胞物质并诊断AM。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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