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Annals of Surgical Oncology

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01-01-2005 | Original Article

Lymph Node Metastasis in Epithelial Malignancies of the Appendix With Peritoneal Dissemination Does Not Reduce Survival in Patients Treated by Cytoreductive Surgery and Perioperative Intraperitoneal Chemotherapy

Authors: S. González-Moreno, MD, PhD, E. Brun, MD, FCAP, FASCP, P. H. Sugarbaker, MD, FACS, FRCS

Published in: Annals of Surgical Oncology | Issue 1/2005

Abstract

Background

Peritoneal dissemination of appendiceal malignancy combined with regional lymph node metastasis is an unusual combination of patterns of cancer dissemination.

Methods

A database of 501 appendiceal malignancy patients, all with documented peritoneal seeding, was used to identify 25 patients with involvement of the regional lymph nodes. All patients were uniformly treated with cytoreductive surgery plus perioperative intraperitoneal chemotherapy with mitomycin C and 5-fluorouracil. The clinical and pathologic features of the lymph node–positive patients were compared with those of the lymph node–negative patients. The effect of regional lymph node involvement on survival was determined. Within the group of lymph node–positive patients, clinical and pathologic features were tested for their effect on survival.

Results

When compared with patients with no apparent lymph node positivity, patients with positive lymph nodes were more likely to have an acute abdomen as the initial presentation (P < .001). The intestinal (nonmucinous) histological type was more common (P < .001), and the disseminated peritoneal adenomucinosis histology was less common (P < .001). Survival with the aggressive treatment strategy used in these patients was not different for lymph node–positive as compared with lymph node–negative patients (P = .15 by univariate and P = .38 by multivariate analysis).

Conclusions

Appendiceal malignancy with dissemination to the lymph nodes has a more acute onset and a more frequent nonmucinous histology. With aggressive treatment strategies, lymph node–positive patients did not show a statistically significantly diminished survival.

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Title: Lymph Node Metastasis in Epithelial Malignancies of the Appendix With Peritoneal Dissemination Does Not Reduce Survival in Patients Treated by Cytoreductive Surgery and Perioperative Intraperitoneal Chemotherapy
Authors: S. González-Moreno, MD, PhD
E. Brun, MD, FCAP, FASCP
P. H. Sugarbaker, MD, FACS, FRCS
Publication date: 01-01-2005
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 1/2005
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1007/s10434-004-1161-5

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Lymph Node Metastasis in Epithelial Malignancies of the Appendix With Peritoneal Dissemination Does Not Reduce Survival in Patients Treated by Cytoreductive Surgery and Perioperative Intraperitoneal Chemotherapy

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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