This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Baratti, D. Articles by Deraco, M. Search for Related Content PubMed PubMed Citation Articles by Baratti, D. Articles by Deraco, M.

Prognostic Value of Circulating Tumor Markers in Patients with Pseudomyxoma Peritonei Treated with Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

¹ Department of Surgery, National Cancer Institute, Milan, Italy
² Department of Nuclear Medicine, National Cancer Institute, Milan, Italy
³ Department of Surgery, University of Messina, Messina, Italy

Correspondence: Address correspondence and reprint requests to: Marcello Deraco, MD; E-mail: marcello.deraco{at}istitutotumori.mi.it

Background: Encouraging results have been recently reported in selected patients affected by pseudomyxoma peritonei (PMP) treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). The selection factors predicting clinical outcome are still a matter of clinical investigation. We assessed the prognostic reliability of serum tumor markers in a large series of patients with PMP undergoing CRS and HIPEC.

Methods: Sixty-two patients with PMP were operated on at a single institution with the intent of performing adequate CRS (residual tumor nodules 2.5mm) and HIPEC. Baseline and serial marker measurements were prospectively collected and tested by multivariate analysis with respect to adequate cytoreduction, overall (OS) and progression-free (PFS) survival, along with the following variables: age, sex, performance status, prior surgical score, histological subtype, prior systemic chemotherapy, disease extent, completeness of cytoreduction.

Results: Baseline diagnostic sensitivity was 72.6% for CEA, 58.1% for CA19.9, 58.7% for CA125, 36.1% for CA15.3. Fifty-three patients underwent adequate CRS and HIPEC; gross residual tumor was left after surgery in nine. Adequate CRS was performed in 19/27 patients with elevated and in 19/19 with normal baseline CA125 (P = .0140). The other markers were unable to predict the completeness of CRS by univariate analysis. Baseline elevated CA19.9 was an independent predictor of reduced PFS; inadequate CRS and aggressive histology were independent prognostic factors for both reduced OS and PFS.

Conclusion: Normal CA125 correlated to the likelihood to achieve adequate CRS, which is a significant prognostic factor for PMP. Increased baseline CA19.9 was an independent predictor of worse PFS after CRS and HIPEC.

Key Words: Pseudomyxoma peritonei • Serum tumor markers • Peritonectomy • Hyperthermic intraperitoneal chemotherapy • HIPEC • CA125 • CA19.9

This article has been cited by other articles:

				D. Baratti, S. Kusamura, D. Nonaka, M. Langer, S. Andreola, M. Favaro, C. Gavazzi, B. Laterza, and M. Deraco Pseudomyxoma Peritonei: Clinical Pathological and Biological Prognostic Factors in Patients Treated with Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Ann. Surg. Oncol., February 1, 2008; 15(2): 526 - 534. [Abstract] [Full Text] [PDF]