Annals of Surgical Oncology

, Volume 18, Issue 6, pp 1540–1546

Surgical Cytoreduction and Survival in Appendiceal Cancer Peritoneal Carcinomatosis: An Evaluation of 46 Consecutive Patients

  • Terence C. Chua
  • Ihssan Al-Alem
  • Akshat Saxena
  • Winston Liauw
  • David L. Morris
Colorectal Cancer

DOI: 10.1245/s10434-011-1714-3

Cite this article as:
Chua, T.C., Al-Alem, I., Saxena, A. et al. Ann Surg Oncol (2011) 18: 1540. doi:10.1245/s10434-011-1714-3

Abstract

Background

Surgical cytoreduction and intraperitoneal chemotherapy is increasingly accepted as an effective treatment modality for mucinous appendiceal neoplasm. For the majority of patients with low-grade histology, outcomes have been encouraging. The survival of patients with neoplasms of malignant character is protracted and this study was designed to evaluate the effectiveness of this surgical strategy on outcomes.

Methods

Forty-six consecutive patients with mucinous and nonmucinous appendiceal cancer with peritoneal dissemination were studied. Clinicopathological and treatment related factors were obtained from a prospective database. The study’s end points of disease-free survival (DFS) and overall survival (OS) were analyzed using the Kaplan-Meier method.

Results

The median DFS and OS after cytoreduction were 20.5 and 56.4 months respectively. Five-year overall survival rate was 45%. Five independent factors associated with DFS and OS were identified through a multivariate analysis: age (DFS p = 0.001, OS p = 0.002), completeness of cytoreduction (DFS p = 0.001, OS p = 0.003), previous chemotherapy treatment (DFS p = 0.021), CA 199 levels (DFS p = 0.013), and tumor grade (OS p = 0.005).

Conclusions

Cytoreductive surgery and intraperitoneal chemotherapy may achieve long-term survival in appendiceal malignancies with peritoneal dissemination for which the predictors of outcomes identified through this study may tailor the disease management to commit patients early toward this successful surgical strategy.

Copyright information

© Society of Surgical Oncology 2011

Authors and Affiliations

  • Terence C. Chua
    • 1
  • Ihssan Al-Alem
    • 1
  • Akshat Saxena
    • 1
  • Winston Liauw
    • 2
  • David L. Morris
    • 1
  1. 1.Hepatobiliary and Surgical Oncology UnitUNSW Department of Surgery, St George HospitalSydneyAustralia
  2. 2.Department of Medical OncologyCancer Care Centre, St George HospitalSydneyAustralia