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World Journal of Surgical Oncology

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Open Access 01-12-2016 | Research

Early identification of DPAM in at-risk low-grade appendiceal mucinous neoplasm patients: a new approach to surveillance for peritoneal metastasis

Authors: Jason M. Foster, Richard L. Sleightholm, Steve Wahlmeier, Brian Loggie, Poonam Sharma, Asish Patel

Published in: World Journal of Surgical Oncology | Issue 1/2016

Abstract

Background

Disseminated peritoneal adenomucinosis (DPAM) patients often have a history of appendectomy with identification of an incidental mucinous neoplasm (low-grade appendiceal mucinous neoplasm (LAMN)). The rate of developing DPAM is not well established.

Methods

Twenty-two patients with incidental LAMN were identified and monitored with cancer markers and CT every 4–6 months. Laparoscopy with peritoneal washing was performed in patients either in the event of radiographic disease or after 12 months in absence of radiographic disease. The rate of detecting peritoneal metastasis was determined for CT scan and laparoscopy.

Results

Peritoneal metastasis was detected in 5 (23 %) patients. Occult disease was detected in four patients at laparoscopy without a detectable disease on CT scan. One patient developed radiographic progression at 6 months confirmed with laparoscopy. Four patients were treated with cytoreductive surgery (CRS)/HIPEC and one with CRS only. The 17 patients with negative laparoscopy remain disease free with a median follow-up of 50 months.

Conclusions

The rate of peritoneal metastasis in incidental LAMN patients was 23 %. Laparoscopy was the primary screening tool identifying occult metastasis. The median PCI of 7 was low, and all the patients underwent R0/R1 resections. This study revealed 1 in every 4.4 patients with LAMN may develop PMP. Longer follow-up and further patient surveillance is warranted.

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Title: Early identification of DPAM in at-risk low-grade appendiceal mucinous neoplasm patients: a new approach to surveillance for peritoneal metastasis
Authors: Jason M. Foster
Richard L. Sleightholm
Steve Wahlmeier
Brian Loggie
Poonam Sharma
Asish Patel
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: World Journal of Surgical Oncology / Issue 1/2016
Electronic ISSN: 1477-7819
DOI: https://doi.org/10.1186/s12957-016-0996-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Early identification of DPAM in at-risk low-grade appendiceal mucinous neoplasm patients: a new approach to surveillance for peritoneal metastasis

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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