Treatment of peritoneal carcinomatosis from adenocarcinoid of appendiceal origin.

Abstract

Mucinous peritoneal carcinomatosis arising from appendiceal adenocarcinoid is uncommon and treatment options have been poorly defined. This study examined the effect of combined cytoreductive surgery and intraperitoneal chemotherapy on survival in these patients. Of 810 patients with peritoneal malignancy of appendiceal origin treated by cytoreductive surgery and intraperitoneal chemotherapy, 22 patients (mean age 45 years; 17 women) had adenocarcinoid. The overall median survival was 18.5 (range 3.2-95.1) months, with 2- and 5-year survival rates of 39 and 25 per cent respectively. Survival after combined surgery and chemotherapy depended on the Peritoneal Cancer Index (P = 0.008) and the extent of cytoreduction (P = 0.007). Peritoneal carcinomatosis from adenocarcinoid of appendiceal origin is as invasive as peritoneal surface malignancy from colorectal adenocarcinoma. Patients in whom complete or near-complete surgical removal is possible should be considered for cytoreduction in combination with intraperitoneal chemotherapy.