Long term survival outcomes of surgery combined with hyperthermic intraperitoneal chemotherapy for perforated low‐grade appendiceal mucinous neoplasms: A multicenter retrospective study

• Published in: World journal of surgery 2024-01, Vol.48 (1), p.86-96
• Main Authors: Han, Zhenlong, Liu, Xiaodong, Tian, Yulong, Shen, Shuai, Wang, Hongbo, Hu, Shuiqing, Wu, Xudong, Yan, Zhao, Lu, Cunlong, Wang, Peixin, Bai, Yingcheng, Kong, Ying, Wang, Liankai, Cao, Shougen, Li, Zequn, Zhong, Hao, Meng, Cheng, Zhou, Yanbing
• Format: Article
• Language: English
• Subjects: Adenocarcinoma, Mucinous - mortality; Adenocarcinoma, Mucinous - pathology; Adenocarcinoma, Mucinous - therapy; Adult; Aged; Appendiceal Neoplasms - mortality; Appendiceal Neoplasms - pathology; Appendiceal Neoplasms - therapy; Combined Modality Therapy; Female; HIEPC; Humans; Hyperthermic Intraperitoneal Chemotherapy; Intestinal Perforation - etiology; Male; Middle Aged; Neoplasm Grading; perforated LAMN; Peritoneal Neoplasms - mortality; Peritoneal Neoplasms - therapy; Retrospective Studies; survival prognosis; Survival Rate; Treatment Outcome
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1002/wjs.12018

Background Low‐grade appendiceal mucinous neoplasms (LAMN) are very rare, accounting for approximately 0.2%–0.5% of gastrointestinal tumors. We conducted a multicenter retrospective study to explore the impact of different surgical procedures combined with HIPEC on the short‐term outcomes and long‐term survival of patients. Methods We retrospectively analyzed the clinicopathological data of 91 LAMN perforation patients from 9 teaching hospitals over a 10‐year period, and divided them into HIPEC group and non‐HIPEC group based on whether or not underwent HIPEC. Results Of the 91 patients with LAMN, 52 were in the HIPEC group and 39 in the non‐HIPEC group. The Kaplan‐Meier method predicted that 52 patients in the HIPEC group had 5‐ and 10‐year overall survival rates of 82.7% and 76.9%, respectively, compared with predicted survival rates of 51.3% and 46.2% for the 39 patients in the non‐HIPEC group, with a statistically significant difference between the two groups (χ2 = 10.622, p = 0.001; χ2 = 10.995, p = 0.001). Compared to the 5‐year and 10‐year relapse‐free survival rates of 75.0% and 65.4% in the HIPEC group, respectively, the 5‐year and 10‐year relapse‐free survival rates of 48.7% and 46.2% in the non‐HIPEC group were significant different between the two outcomes (χ2 = 8.063, p = 0.005; χ2 = 6.775, p = 0.009). The incidence of postoperative electrolyte disturbances and hypoalbuminemia was significantly higher in the HIPEC group than in the non‐HIPEC group (p = 0.023; p = 0.044). Conclusions This study shows that surgery combined with HIPEC can significantly improve 5‐year and 10‐year overall survival rates and relapse‐free survival rates of LAMN perforation patients, without affecting their short‐term clinical outcomes.