Neoadjuvant FOLFOX Chemotherapy in 34 Consecutive Patients With Mucinous Peritoneal Carcinomatosis of Appendiceal Origin

Background: A treatment option for patients with peritoneal mucinous carcinomatosis (PMCA) from an appendiceal neoplasm is cytoreductive surgery and perioperative intraperitoneal chemotherapy Also, these patients are recommended for systemic chemotherapy using an oxaliplatin and 5-fluorouracil (FOLFOX) regimen A major question concerns the proper timing (neoadjuvant vs adjuvant) of the systemic chemotherapy Methods: In January of 2005 a prospective study was in to routinely treat patients with peritoneal dissemination of a mucinous adenocarcinoma of the appendix with neoadjuvant chemotherapy using FOLFOX All patients had a clinical. CT, intraoperative, and histopathological assessment of chemotherapy effects The study was closed in July of 2009 Results: Thirty-four consecutive patients were available for evaluation In the clinical evaluation and CT evaluation. 24 (71%) and 22 (65%). respectively. had stable disease on chemotherapy By intraoperative examination 17 (50%) patients were observed to have progressed By histopathology seven had a partial response and three patients a complete response (29%) Conclusions: In these carcinomatosis patients clinical and CT assessment of response to neoadjuvant chemotherapy seldom provided useful data over this short time period Intraoperative tindings indicated progression in 50% of patients By histopathology. 29% of patients had a response J Surg Oncol. 2010.102 576-581 (C) 2010 Wiley-Liss. Inc