Recommendations in the management of epithelial appendiceal neoplasms and peritoneal dissemination from mucinous tumours (pseudomyxoma peritonei)
Por:
Barrios, P, Losa, F, Gonzalez-Moreno, S, Rojo, A, Gomez-Portilla, A, Bretcha-Boix, P, Ramos, I, Torres-Melero, J, Salazar, R, Benavides, M, Massuti, T and Aranda, E
Publicada:
1 may 2016
Resumen:
The epithelial appendiceal neoplasms are uncommon and are usually
detected as an unexpected surgical finding. The general surgeon should
be aware of the diversity of its clinical manifestations and biological
behaviors along with the significance of the surgical treatment on the
progression of the illness and the prognosis of the patients. The
operative findings and, especially, tumor histology, determine the type
of surgery. Intestinal histologic subtype behaves and should be treated
similarly to the right colon neoplasms; while mucinous tumors, often
discordant between histology and its aggressiveness, can be treated with
a simple appendectomy or require complex oncological surgeries. Mucinous
tumors are often associated with the presence of mucin or tumor implants
in the abdominal cavity, being the clinical syndrome known as
pseudomyxoma peritonei (PMP). PMP tends to present an indolent but
deadly evolution and requires a multimodal approach as a single
treatment with curative potential: complete cytoreductive surgery plus
hyperthermic Intra-peritoneal chemotherapy (CCRS + HIPEC) now considered
the standard of care in this pathology. The general surgeon should be
aware of the governing principles of the treatment of appendiceal
neoplasms with or without peritoneal dissemination, know the therapeutic
frontiers in every situation (avoiding unnecessary or counterproductive
surgeries) and sending early these patients to specialised centres in
the radical management of malignant diseases of the peritoneum in the
conditions and with the necessary information to facilitate a possible
radical treatment.
Filiaciones:
Barrios, P:
Univ Barcelona, Consorci Sanitari Integral H St Joan Despi Moises, Barcelona, Spain
Univ Barcelona, Barcelona, Spain
Losa, F:
Univ Barcelona, Consorci Sanitari Integral H St Joan Despi Moises, Barcelona, Spain
Gonzalez-Moreno, S:
Anderson Canc Ctr, Madrid, Spain
Rojo, A:
Anderson Canc Ctr, Madrid, Spain
Gomez-Portilla, A:
Hosp San Jose, Vitoria, Spain
Bretcha-Boix, P:
Hosp Quiron Salud Torrevieja, Alicante, Spain
Ramos, I:
Univ Barcelona, Consorci Sanitari Integral H St Joan Despi Moises, Barcelona, Spain
Torres-Melero, J:
Hosp Torrecardenas, Almeria, Spain
Salazar, R:
Inst Catala Oncol ICO L Hosp, Barcelona, Spain
Benavides, M:
Hosp Reg Univ, Malaga, Spain
:
Hosp Gen Alicante, Alicante, Spain
Aranda, E:
Univ Cordoba, Maimonides Inst Biomed Res IMIBIC, Reina Sofia Hosp, Cordoba, Spain
Inst Salud Carlos III, Spanish Canc Network RTICC, Cordoba, Spain
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