Case series on high grade appendiceal cancer with peritoneal and liver carcinomatosis undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC)

Susmit Prosun Roy; Nayef Al Zhahrani; Shoma Barat; David L Morris

doi:10.1016/j.ijscr.2022.107027

Case series on high grade appendiceal cancer with peritoneal and liver carcinomatosis undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC)

Int J Surg Case Rep. 2022 May:94:107027. doi: 10.1016/j.ijscr.2022.107027. Epub 2022 Apr 4.

Authors

Susmit Prosun Roy¹, Nayef Al Zhahrani², Shoma Barat³, David L Morris⁴

Affiliations

¹ General Surgery, John Hunter Hospital, University of Newcastle, Newcastle, Australia; Liver and Peritonectomy Unit, St George Hospital, Kogarah, Australia. Electronic address: [email protected].
² Liver and Peritonectomy Unit, St George Hospital, Kogarah, Australia; College of Medicine, Al Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia. Electronic address: [email protected].
³ Southeast Sydney Local Health District, Australia; University of New South Wales, Australia. Electronic address: [email protected].
⁴ Liver and Peritonectomy Unit, St George Hospital, Kogarah, Australia; University of New South Wales, Australia; Liver and Peritonectomy Unit, St George Hospital, Kogarah, Australia; UNSW, St George and Sutherland Clinical School, NSW 2052, Australia; St George and Sutherland Clinical School, Kogarah, NSW 2217, Australia. Electronic address: [email protected].

Abstract

Background: Pseudomyxoma Peritonei (PMP) is a mucin producing cancer with appendix as primary site. Cytoreductive Surgery (CRS) combined with hyper-thermic intraperitoneal chemotherapy (HIPEC) is an established form of therapy known to prolong survival in patients with PMP and peritoneal carcinomatosis. Methods/patients In our case series, we present five cases of PMP with synchronous liver and peritoneal metastasis treated with CRS and HIPEC. It is a very rare condition which needs more research to be able to comment on overall survival.

Results: However, in our study, we found lower age, female gender and complete cytoreduction in surgery to be favourable predictors for improved morbidity.

Conclusion: In our experience, CRS/HIPEC seem to be feasible for patients with PMP with synchronous liver and peritoneal metastasis.

Keywords: Case series; Cytoreductive surgery; High grade appendiceal cancer; Hyperthermic intraperitoneal chemotherapy; Mitomycin – C; Oxaliplatin; Peritonectomy.