Modern systemic chemotherapy in surgically unresectable XXXX of appendiceal origin: a single-institution experience.

@entity1 @entity2466 @entity146 @entity5 @entity3558 @entity420
BACKGROUND: @entity2466 include @entity5 ranging from benign-appearing cells with widespread @entity3558 deposits to @entity146 poorly differentiated signet ring cell @entity420 . Traditionally, these @entity5 are treated with cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy. For some @entity1 , cytoreductive surgery is not an option, and minimal published data exist in the management and outcome of these @entity1 . A retrospective analysis was conducted to determine the benefit of modern systemic chemotherapy in @entity1 with disseminated @entity2466 who were not considered optimal candidates for cytoreductive surgery. METHODS: A retrospective review was conducted using The University of Texas M. D. Anderson Cancer Center @entity5 registry between January 2000 and July 2005. Response was determined by radiographic response and/or overall clinical benefit. RESULTS: Of 186 @entity1 diagnosed with @entity2466 , 54 (29%) @entity1 considered to be suboptimal surgical candidates received > or =2 cycles of systemic chemotherapy. Thirty (55.6%) @entity1 had a disease control rate noted as a complete response, partial response, or stable disease. After a median follow-up of 24 months, the median progression-free survival (PFS) and overall survival were determined to be 7.6 months (95% confidence interval [CI], 4-11) and 56 months (95% CI, 36-not applicable), respectively. CONCLUSIONS: Systemic chemotherapy has a role in @entity2466 @entity1 who are suboptimal candidates for cytoreductive surgery. The intermediate PFS indicates the challenges that exist for @entity2466 @entity1 in this setting. Prospective randomized trials including systemic chemotherapy are needed to provide further insight into this malignancy, for which no standard exists.
