Operative findings, early complications, and long-term survival in 456 @entity1 with XXXX of appendiceal origin.

@entity1 @entity5 @entity843 @entity1138 @entity1725
BACKGROUND: @entity1725 is a clinical entity characterized by @entity843 usually originating from a perforated mucinous @entity5 . Currently optimal therapy is considered complete @entity5 removal (complete cytoreduction) combined with heated intraperitoneal chemotherapy. When complete cytoreduction is not achievable, major @entity5 debulking is undertaken. The long-term follow-up of @entity1 undergoing surgery for perforated @entity5 in a national @entity1725 center is reported. METHODS: Between March 1994 and July 2009, 456 @entity1 with @entity1725 from perforated @entity5 underwent surgery. The treatment strategy involved a combination of cytoreductve surgery aiming for @entity5 removal, combined with hyperthermic intraperitoneal chemotherapy with @entity1138 . Where @entity5 removal was not possible, maximal @entity5 debulking was performed. Perioperative outcomes and predicted 5- and 10-year survival are reported. RESULTS: Overall 15 of 456 (3%) @entity5 were not resectable at laparotomy. Of the 441 @entity1 who had resection, 289 (66%) had complete cytoreduction and 152 (34%) had major @entity5 debulking. Postoperative in-hospital mortality was 1.6% and grade 3/4 morbidity was 7%. The Kaplan-Meier method predicted 5- and 10-year overall survival of 69% and 57%, respectively. Five- and 10-year predicted survival was 87% and 74% for the 289 @entity1 who had complete cytoreduction compared with 34% and 23% for the 152 who had major @entity5 debulking. CONCLUSION: @entity5 removal was achieved in 289 of 441 (66%) @entity1 with peritoneal dissemination from perforated @entity5 with good long-term survival and probable cure in more than two-thirds.
