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Titolo:
Patients with pseudomyxoma peritonei associated with disseminated peritoneal adenomucinosis have a significantly more favorable prognosis than patients with peritoneal mucinous carcinomatosis
Autore:
Ronnett, BM; Yan, H; Kurman, RJ; Shmookler, BM; Wu, L; Sugarbaker, PH;
Indirizzi:
Johns Hopkins Hosp, Dept Pathol, Baltimore, MD 21231 USA Johns Hopkins Hosp Baltimore MD USA 21231 Pathol, Baltimore, MD 21231 USA Johns Hopkins Hosp, Dept Obstet & Gynecol, Baltimore, MD 21231 USA Johns Hopkins Hosp Baltimore MD USA 21231 ynecol, Baltimore, MD 21231 USA Washington Hosp Ctr & Canc Inst, Washington, DC USA Washington Hosp Ctr & Canc Inst Washington DC USA st, Washington, DC USA Acad Oncol Resources LLC, Rockville, MD USA Acad Oncol Resources LLC Rockville MD USA sources LLC, Rockville, MD USA Johns Hopkins Univ, Sch Publ Hlth, Div Human Nutr, Baltimore, MD USA JohnsHopkins Univ Baltimore MD USA h, Div Human Nutr, Baltimore, MD USA
Titolo Testata:
CANCER
fascicolo: 1, volume: 92, anno: 2001,
pagine: 85 - 91
SICI:
0008-543X(20010701)92:1<85:PWPPAW>2.0.ZU;2-S
Fonte:
ISI
Lingua:
ENG
Soggetto:
INTRAPERITONEAL CHEMOTHERAPY; CLINICOPATHOLOGICAL ANALYSIS; CYTOREDUCTIVE SURGERY; APPENDICEAL ORIGIN; TUMORS; EMPHASIS; OVARY; WOMEN; SITE; FEATURES;
Keywords:
pseudomyxoma peritonei; disseminated peritoneal adenomucinosis; peritoneal mucinous carcinomatosis; mucinous adenoma; mucinous adenocarcinoma; appendix;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
15
Recensione:
Indirizzi per estratti:
Indirizzo: Ronnett, BM Johns Hopkins Hosp, Dept Pathol, Weinberg Bldg,Room 2242,401 NBroadway, Baltimore, MD 21231 USA Johns Hopkins Hosp Weinberg Bldg,Room 2242,401 N Broadway Baltimore MD USA 21231
Citazione:
B.M. Ronnett et al., "Patients with pseudomyxoma peritonei associated with disseminated peritoneal adenomucinosis have a significantly more favorable prognosis than patients with peritoneal mucinous carcinomatosis", CANCER, 92(1), 2001, pp. 85-91

Abstract

BACKGROUND. Pseudomyxoma peritonei (PMP) is a poorly understood condition characterized by disseminated intraperitoneal mucinous tumors, often with mucinous ascites. The term PMP has been applied historically as a pathologicdiagnostic term to both benign and malignant mucinous neoplasms that produce abundant extracellular mucin, resulting in a variable and poorly predictable prognosis. A recent study reported a pathologic classification that separated patients into prognostically distinct groups, but the follow-up wasrelatively short. METHODS. Long-term follow-up data were analyzed for a previously reported series of 109 patients with PMP to examine the prognostic utility of a pathologic classification system that divided patients into three groups: disseminated peritoneal adenomucinosis (DPAM), peritoneal mucinous carcinomatosis (PMCA), and peritoneal mucinous carcinomatosis with intermediate or discordant features (PMCA-I/D). Patients whose tumors were classified 25 DPAM (n= 65 patients) had disease that was characterized by histologically bland to low-grade adenomatous mucinous epithelium associated with abundant extracellular mucin and fibrosis, often with an identifiable appendiceal mucinous adenoma that was the source of the peritoneal lesions. Patients whose tumors were classified 25 PMCA (n = 30 patients) had disease that was characterized by peritoneal lesions that displayed the cytologic and architectural features of mucinous carcinoma associated with extracellular mucin, often with an identifiable invasive mucinous adenocarcinoma of the gastrointestinal tract. Patients whose tumors were classified 25 PMCA-I (n = 11 patients) had peritoneal lesions that combined the features of DPAM and PMCA derived from well differentiated mucinous adenocarcinomas associated with adenomas. Patients whose tumors were classified 25 PMCA-D (n = 3 patients) had markedly atypical appendiceal adenomas associated with peritoneal lesions similar to PMCA. RESULTS. Patients with DPAM had 5-year and 10-year survival rates of 75% and 68%, respectively (mean follow-up, 96 months; median follow-up, 104 months). Patients with PMCA and PMCA-I/D had a significantly worse prognosis, with 5-year and 10-year survival rates, respectively, of 50% and 21% for PMCA-I/D (mean follow-up, 58 months; median follow-up, 51 months) and 14% and 3% for PMCA (mean follow-up, 27 months; median follow-up, 16 months; P = 0.0001). CONCLUSIONS. The term PMP should be used only as a clinical descriptor forpatients who have the syndrome of mucinous ascites accompanied by a characteristic distribution of peritoneal mucinous tumors with the pathologic features of DPAM. DPAM should be used as a pathologic diagnostic term for patients with the bland peritoneal mucinous tumors associated with ruptured appendiceal mucinous adenomas and PMP. These patients should not be diagnosed with carcinoma, because they have disease that is distinct pathologically and prognostically from PMCA. Cancer 2001;92:85-91. (C) 2001 American CancerSociety.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 26/09/20 alle ore 11:08:34