ASO Author Reflections: Incomplete Cytoreduction Prediction Model for Pseudomyxoma Peritonei

Abstract Background Pseudomyxoma peritonei (PMP) is a rare disease, the prognosis of overall survival (OS) is affected by many factors, present study aim to screen independent prediction indicators for PMP and establish prediction model for OS rates in PMP.Methods 119 PMP patients received cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) in our center for the first time were included between 01/06/2013 and 22/11/2019 . The log-rank test was used to compare the OS rate among groups, subsequently, variables with P<0.10 were subjected to multivariate Cox model for screening independent prediction indicators. Finally, the prediction models for OS in PMP will be established.Results Univariate analysis showed that Barthel Index Score, albumin, D-dimer, CEA, CA125, CA19-9, CA724, CA242, PCI, degree of radical surgery, histopathological grade were signiﬁcant predictors for OS in PMP. At multivariate analysis, sex, D-dimer, CA125, CA19-9, and degree of radical surgery were independently associated with OS rate in PMP. ROC analysis was performed to calculate discrimination ability of prediction model and the area under curves (AUC) was 0.902 (95%CI: 0.823-0.954). Finally, nomogram was plotted by the independent predictive factors for PMP.Conclusions Several factors (sex, degree of radical surgery, D-dimer, preoperative CA125 and CA19-9) have independent prognostic value for survival in PMP, the tumor based prediction model has better prediction value, more researches are need to verify and improve the prediction model.

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Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy for Pseudomyxoma Peritonei of Appendiceal Origin: A Single Center Experience

Frontiers in Surgery ◽

10.3389/fsurg.2021.715119 ◽

2021 ◽

Vol 8 ◽

Author(s):

Francesco Santullo ◽

Fabio Pacelli ◽

Carlo Abatini ◽

Miriam Attalla El Halabieh ◽

Giusy Fortunato ◽

...

Keyword(s):

Survival Rate ◽

Intraperitoneal Chemotherapy ◽

Cytoreductive Surgery ◽

Pseudomyxoma Peritonei ◽

Hyperthermic Intraperitoneal Chemotherapy ◽

Progression Free Survival ◽

Free Survival ◽

Crs And Hipec ◽

The Mean ◽

Incomplete Cytoreduction

Background: Pseudomyxoma peritonei (PMP) originating from appendiceal mucinous neoplasm is a rare peritoneal malignancy characterized by the progressive intraperitoneal accumulation of mucus leading to death if left untreated. In recent years, cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) offered increased survival rates. This study aims to identify the clinical, pathological, and surgical features influencing safety and survival outcomes of patients undergoing CRS and HIPEC for PMP of appendiceal origin.Methods: A retrospective analysis of all patients undergoing CRS and HIPEC for PMP of appendiceal origin from January 2015 to May 2019 was conducted at our institution.Results: Study population included 50 patients (74% female, 26% male). The median age at CRS was 60 (38–84). The median peritoneal cancer index (PCI) was 17. Complete cytoreductive surgery (CC 0–1) was achieved in 47 patients (94%). HIPEC chemotherapeutic regimen was based on oxaliplatin for 13 (28%) patients and mitomycin for 34 (72%) patients. We experienced a total of 19 (38%) postoperative complications, of which 14 (74%) of grade I-II and 5 (26%) of grade III-IV, according to the Clavien-Dindo classification. The median follow-up period was 27 months (12–107) from the date of cytoreductive surgery. The mean survival rate was 100 months, with a 5-year OS of 91%. The mean progression-free survival rate was 77 months (0–107), with a 5-year PFS of 63%. Multivariate analysis identified adenocarcinoma histotype and incomplete cytoreduction to significantly worsen progression-free survival, while incomplete cytoreduction was the only independent predictor of poorer overall survival.Conclusion: Complete cytoreduction and appendiceal neoplasm histotype play a crucial role in the survival of patients affected by PMP of appendiceal origin. The rates of morbidity associated with CRS and HIPEC for PMP are acceptable.

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Circulating tumor markers: Predictors of incomplete cytoreduction and powerful determinants of outcome in pseudomyxoma peritonei

Journal of Surgical Oncology ◽

10.1002/jso.23329 ◽

2013 ◽

Vol 108 (1) ◽

pp. 1-8 ◽

Cited By ~ 18

Author(s):

Shigeki Kusamura ◽

Ionut Hutanu ◽

Dario Baratti ◽

Marcello Deraco

Keyword(s):

Tumor Markers ◽

Pseudomyxoma Peritonei ◽

Incomplete Cytoreduction

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Tumor marker based survival analysis for patients with pseudomyxoma peritonei of appendiceal origin: A retrospective cohort study

10.21203/rs.3.rs-39824/v2 ◽

2020 ◽

Author(s):

Mingjian Bai ◽

Shilong Wang ◽

Ruiqing Ma ◽

Ying Cai ◽

Yiyan Lu ◽

...

Keyword(s):

Prediction Model ◽

Pseudomyxoma Peritonei ◽

Prediction Models ◽

Radical Surgery ◽

Cox Model ◽

Univariate Analysis ◽

Rank Test ◽

Internal Validation ◽

Discrimination Ability ◽

D Dimer

Abstract Background Pseudomyxoma peritonei (PMP) is a rare disease, the prognosis of overall survival (OS) is affected by many factors, present study aim to screen independent prediction indicators and establish a nomogram for PMP. Methods 119 PMP patients received cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) in our center for the first time were included between 01/06/2013 and 22/11/2019 . The log-rank test was used to compare the OS rate among groups, subsequently, variables with P<0.10 were subjected to multivariate Cox model for screening independent prediction indicators. Finally, the nomogram prediction models will be established. Results Univariate analysis showed that Barthel Index Score, Albumin, D-Dimer, CEA, CA125, CA19-9, CA724, CA242, PCI, degree of radical surgery, histopathological grade were signiﬁcant predictors for OS in PMP. At multivariate analysis, Sex, D-Dimer, CA125, CA19-9, PCI, and degree of radical surgery were independently associated with OS rate in PMP. A nomogram was plotted based on the independent predictive factors for PMP and undergone internal validation, ROC analysis was performed to calculate discrimination ability of prediction model, the area under curves (AUC) was 0.880 (95% CI : 0.806- 0.933). Conclusions Several factors (Sex, D-Dimer, CA125, CA19-9, PCI, and degree of radical surgery) have independent prognostic value for survival in PMP, the tumor based prediction model has a better prediction value, more researches are need to verify and improve the prediction model.

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