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Peritoneal Carcinomatosis of Urachus Origin Treated by Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC): An International Registry of 36 Patients

  • Urologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

Peritoneal carcinomatosis or pseudomyxoma peritonei from urachus is a rare form of presentation, often diagnosed at an advanced state of tumor burden. Because of its rarity, little is known about its natural history, prognosis, or optimal treatment. We searched a large international multicenter database of peritoneal surface disease to identify cases of peritoneal carcinomatosis of urachus that were treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) at expert centers. The aim is to improve knowledge and understanding of the disease and standardize its treatment.

Methods

A prospective multicenter international database was retrospectively searched to identify all patients with urachus tumor and peritoneal metastases who underwent CRS and HIPEC through the Peritoneal Surface Oncology Group International (PSOGI). Postoperative complications, long-term results, and principal prognostic factors were analyzed.

Results

The analysis included 36 patients. After median follow-up of 48 months, median overall survival (OS) was 58.5 months. Three- and 5-year OS was 55.4 and 46.2%, respectively. Patients who underwent complete macroscopic CRS had significantly better survival than those treated with incomplete CRS, with median OS not achieved and of 20.1 months, respectively [95% confidence interval (CI) 4.4–30.5, p < 0.001]. There were no postoperative deaths, and 37.9% of patients had major complications.

Conclusion

CRS and HIPEC may increase long-term survival in selected patients with peritoneal metastases of urachus origin, especially when complete CRS is achieved.

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Acknowledgement

The authors thank Peggy Jourdan-Enfer and Anaïs Poulet for their expert help with data collection. The authors thank Lorna Saint Ange for help with editing the manuscript, and Evelyne Decullier for help with data analysis.

The collaborators of the BIG-RENAPE Working Group include the following: J. Abba (Department of Surgical Oncology, CHU Grenoble University, Grenoble, France); K. Abboud (Department of Surgical Oncology, CHU St Etienne, St Etienne, France); M. Alyami (Department of Surgical Oncology, Centre Hospitalier Lyon Sud - EMR 3738, Lyon 1 University, Lyon, France); C. Arvieux (Department of Surgical Oncology, CHU Grenoble University, Grenoble, France); N. Bakrin (Department of Surgical Oncology, Centre Hospitalier Lyon Sud - EMR 3738, Lyon 1 University, Lyon, France); J.-M. Bereder (Department of Surgical Oncology, CHU L’Archet 2, Nice, France); D. Bouzard (Department of Surgical Oncology, CHU Louis Mourier, Colombes, France); C. Brigand (Department of Surgical Oncology, CHRU Hautepierre, Strasbourg, France); S. Carrère (Department of Surgical Oncology, Institut du Cancer de Montpellier, Montpellier, France); D. Delroeux (Department of Surgical Oncology, CHU Jean Minjoz, Besançon, France); F. Dumont (Department of Surgical Oncology, ICO - René Gauducheau, St Herblain, France); C. Eveno (Department of Surgical Oncology, CHU Lariboisière, Paris, France); O. Facy (Department of Surgical Oncology, CHU Dijon, Dijon, France); F. Guyon (Department of Surgical Oncology, Institut Bergonié, Bordeaux, France); G. Ferron (Department of Surgical Oncology, IUCT Oncopole, Toulouse, France); R. Kianmanesh (Department of Surgical Oncology, CHU Robert Debré, Reims, France); R. Lo Dico (Department of Surgical Oncology, CHU Lariboisière, Paris, France); G. Lorimier (Department of Surgical Oncology, CHU Angers, Angers, France); F. Marchal (Department of Surgical Oncology, Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France); P. Mariani (Department of Surgical Oncology, Institut Curie, Paris, France); P. Meeus (Department of Surgical Oncology, Centre Léon Bérard, Lyon, France); S. Msika (Department of Surgical Oncology, CHU Louis Mourier, Colombes, France); P. Ortega-Deballon (Department of Surgical Oncology, CHU Dijon, Dijon, France); B. Paquette (Department of Surgical Oncology, CHU Jean Minjoz, Besançon, France); P. Peyrat (Department of Surgical Oncology, Centre Léon Bérard, Lyon, France); N. Pirro (Department of Surgical Oncology, CHU La Timône, Marseille, France); M. Pocard (Department of Surgical Oncology, CHU Lariboisière, Paris, France); J. Porcheron (Department of Surgical Oncology, CHU St Etienne, St Etienne, France); F. Quenet (Department of Surgical Oncology, Institut du Cancer de Montpellier, Montpellier, France); P. Rat (Department of Surgical Oncology, CHU Dijon, Dijon, France); O. Sgarbura (Department of Surgical Oncology, Institut du Cancer de Montpellier, Montpellier, France); E. Thibaudeau (Department of Surgical Oncology, ICO - René Gauducheau, St Herblain, France); J.-J. Tuech (Department of Surgical Oncology, CHU Charles Nicolle, Rouen, France); F. Zinzindohoue (Department of Surgical Oncology, Hôpital Européen Georges Pompidou, Paris, France).

The collaborators of the PSOGI Working Group include the following: S. A. Ahrendt (Department of Surgery, University of Pittsburgh Medical Center Shadyside Hospital, Pittsburgh, USA); E. Akaishi (Department of Surgical Oncology, Centro de Oncologia Hospital Sirio Libanes, Sao Paolo, Brazil); S. H. Baik (Department of Surgery, Gangnam Severance Hospital - Yonsei University College of Medicine, Seoul, Korea); D. Baratti (Department of Gastrointestinal Surgery, San Raffaele Scientific Institute, Milan, Italy); A. Bhatt (Department of Surgical Oncology, Fortis Hospitals Limited, Bangalore, India); P. Cachin (Department of Surgery, Akademiska sjukhuset, Uppsala University Hospital, Uppasala, Sweden); W. Ceelen (Department of Gastrointestinal Surgery, Gent University Hospital, Ghent, Belgium); I. De Hingh (Department of Surgery, Catharina Ziekenhuis, Eindhoven, The Netherlands); M. De Simone (Department of Surgical Oncology, Candiolo Cancer Institute - FPO, IRCCS, Turin, Italy); P. Dubé (Department of Surgery, University of Montreal, Montreal, Canada); R. P. Edwards (Department of Surgery, University of Pittsburgh Medical Center Shadyside Hospital, Pittsburgh, USA); J. Franko (Department of Surgical Oncology, Mercy Medical Center, Baltimore, USA); L. Gonzalez-Bayon (Department of Surgical Oncology, Hospital Gregorio Marañón, Madrid, Spain); V. Gushchin (Department of Surgical Oncology, Mercy Medical Center, Baltimore, USA); M. P. Holtzman (Department of Surgery, University of Pittsburgh Medical Center Shadyside Hospital, Pittsburgh, USA); M.-C. Hsieh (Department of General Surgery, Wan-Fang Hospital, Taipei, Taiwan); D. Kecmanovic (Department of Surgery, First Surgical Clinic, Clinical Center of Serbia, Belgrade, Serbia); K. W. Lee (Department of Surgery, University of Pittsburgh Medical Center Shadyside Hospital, Pittsburgh, USA); K. Lehmann (Department of Surgery and Transplantation, University Hospital of Zurich, Zurich, Switzerland); Y. Liu (NPO to Support Peritoneal Surface Malignancy Treatment, Kyoto, Japan); S. Mehta (Division of Peritoneal Surface Oncology, Saifee Hospital, Mumbai, India); D. L. Morris (Department of Surgery, University of New South Wales, Sydney, Australia); S. O’Dwyer (Department of Colorectal Surgery, Christie Cancer Center, Manchester, UK); E. Orsenigo (Department of Gastrointestinal Surgery, San Raffaele Scientific Institute, Milan, Italy); P. K. Pande (Department of Surgical Oncology, BLK Superspeciality Hospital, New Delhi, India); E. J. Park (Department of Surgery, Gangnam Severance Hospital - Yonsei University College of Medicine, Seoul, Korea); J. F. Pingpank (Department of Surgery, University of Pittsburgh Medical Center Shadyside Hospital, Pittsburgh, USA); P. Piso (Department of Surgery, University of Regensburg, Regensburg, Germany); F. Rajan (Department of Surgical Oncology, Kovai Medical Centre, Coimbatore, India); B. Rau (Department of Surgical Oncology, Charite Campus Mitte University of Berlin, Berlin, Germany); A. Sardi (Department of Surgical Oncology, Mercy Medical Center Baltimore, USA); L. Sideris (Department of Surgery, University of Montreal, Montreal, Canada); A. Sommariva (Melanoma and Sarcoma Unit, Istituto Oncologico Veneto, Padua, Italy); J. Spiliotis (First Department of Surgical Oncology, Metaxa Cancer Memorial Hospital, Piraeus, Greece); A. A. K. Tentes (Department of Surgery, Metropolitan Hospital, Athens, Greece); M. Teo (Department of Surgical Oncology, National Cancer Centre Singapore, Singapore, Singapore); R. Yarema (Department of Oncology and Medical Radiology Danylo Halytsky Lviv National Medical University, Lviv, Ukraine); R. Younan (Department of Surgery, Centre Hospitalier de l’Université de Montréal, Montreal, Canada); S. S. Zaveri (Department of Surgical Oncology, Manipal Hospital, Bangalore, India); H. J. Zeh (Department of Surgery, University of Pittsburgh Medical Center, Shadyside Hospital, Pittsburgh, USA).

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Correspondence to Olivier Glehen MD, PhD.

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Collaborators (PSOGI and BIG-RENAPE Working Groups) are listed in the “Acknowledgement”.

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Mercier, F., Passot, G., Villeneuve, L. et al. Peritoneal Carcinomatosis of Urachus Origin Treated by Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC): An International Registry of 36 Patients. Ann Surg Oncol 25, 1094–1100 (2018). https://doi.org/10.1245/s10434-017-6299-z

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