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Titolo:
Histopathologic analysis in 46 patients with pseudomyxoma peritonei syndrome: Failure versus success with a second-look operation
Autore:
Yan, H; Pestieau, SR; Shmookler, BM; Sugarbaker, PH;
Indirizzi:
Washington Hosp Ctr, Inst Canc, Washington, DC 20010 USA Washington Hosp Ctr Washington DC USA 20010 anc, Washington, DC 20010 USA Washington Hosp Ctr, Dept Pathol, Washington, DC 20010 USA Washington HospCtr Washington DC USA 20010 hol, Washington, DC 20010 USA Acad Oncol Resources LLC, Rockville, MD USA Acad Oncol Resources LLC Rockville MD USA sources LLC, Rockville, MD USA
Titolo Testata:
MODERN PATHOLOGY
fascicolo: 3, volume: 14, anno: 2001,
pagine: 164 - 171
SICI:
0893-3952(200103)14:3<164:HAI4PW>2.0.ZU;2-2
Fonte:
ISI
Lingua:
ENG
Soggetto:
MUCINOUS TUMORS; CLINICOPATHOLOGICAL ANALYSIS; OVARIAN-TUMORS; ORIGIN; EMPHASIS; SITE; CARCINOMATOSIS; PROGNOSIS; APPENDIX; WOMEN;
Keywords:
cytoreductive surgery; disseminated peritoneal adenomucinosis; intraperitoneal chemotherapy; mucinous adenocarcinoma; pseudomyxoma peritonei syndrome; second-look surgery;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
19
Recensione:
Indirizzi per estratti:
Indirizzo: Sugarbaker, PH Washington Hosp Ctr, Inst Canc, 110 Irving St,CG-185 NW, Washington, DC 20010 USA Washington Hosp Ctr 110 Irving St,CG-185 NW Washington DC USA 20010
Citazione:
H. Yan et al., "Histopathologic analysis in 46 patients with pseudomyxoma peritonei syndrome: Failure versus success with a second-look operation", MOD PATHOL, 14(3), 2001, pp. 164-171

Abstract

Pseudomyxoma peritonei syndrome is a disease characterized by mucinous ascites and mucinous tumor disseminated on peritoneal surfaces; the disease almost always originates from a perforated appendiceal epithelial tumor. Histopathologic assessment of aggressive versus noninvasive character of the mucinous tumor has been shown to have an impact on survival in patients treated with cytoreductive surgery and intraperitoneal chemotherapy. Out of a database of 312 patients having a complete cytoreduction for pseudomyxoma peritonei syndrome, 46 patients (24 male and 22 female) had at least one second-look surgery, Before this review, all 46 of these patients were clinically uniformly categorized with a diagnosis of pseudomyxoma peritonei, Using the criteria described by Ronnett and colleagues, all specimens from the multiple surgical procedures performed on these patients were reviewed and reclassified as disseminated peritoneal adenomucinosis (adenomucinosis), adenomucinosis/mucinous adenocarcinoma (hybrid), or mucinous adenocarcinoma. Thereview was performed in a blinded fashion by a single pathologist (KY), Tofacilitate a critical evaluation of these histopathologic assessments, thepatients were separated into two groups: (1) 19 patients who had a second-look surgery that was unsuccessful in that they went on to die of their disease or in that they currently have disease progression and a limited survival and (2) 27 patients who had a successful second look and currently continue disease free with a minimum 3-year follow-up period, As a result of this review, 11 of 19 patients with an unsuccessful second look and originally designated pseudomyxoma peritonei were reclassified as hybrid-type malignancy (four patients) or mucinous adenocarcinoma (seven patients), Only two patients were reclassified in the successful second-look group (P = .0005),Transitions from a less aggressive to a more invasive histology from one cytoreduction to the next occurred on 13 occasions in patients whose second-look surgery failed and in one patient with a successful second-look surgery (P < .0001), Seven patients retained a histologic classification of disseminated peritoneal adenomucinosis but went on to die of an aggressive disease process. Clinical assessments suggested that failure of second-look surgery for pseudomyxoma peritonei was associated with a biologically more aggressive disease. Unsuccessful second-look surgery for patients with a clinical diagnosis of pseudomyxoma peritonei tumor was often related to an inaccurate initial histologic classification of appendiceal mucinous tumor. Also,a transition from less to more aggressive histology was frequently seen inpatients dying of this disease. Assessment of tumor histology can predict the outcome if a uniform surgical treatment is used in patients with peritoneal dissemination of mucinous epithelial tumors of the appendix.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/10/20 alle ore 02:02:28