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Selection of Patients with Mucinous Carcinomatosis of the Peritoneum for Reoperation Using CT Scan Findings

Description

Patients with mucinous carcinomatosis involving the peritoneal cavity respond best to chemotherapy and have better survival if a complete surgical resection is achieved. A patient's CT scan findings can help determine the chances of whether a complete surgical resection can be achieved. The authors are from the Washington Cancer Institute in Washington, DC.


 

Primary sites for the carcinomas: rectum and appendix

 

The grade of the malignancy affects prognosis, with moderate to poorly differentiated carcinomas having a worse prognosis.

 

Patients with complete resection of the tumor, as defined as no tumor deposits >= 2.5 mm in diameter left behind, had a better prognosis and response to intraperitoneal chemotherapy than did patients with incomplete resection of tumor.

 

Features seen on CT scan different between patients with complete and incomplete resection:

(1) tumor volume in small bowel mesentery

(2) tumor volume in proximal jejunum

(3) tumor volume in distal jejunum

(4) tumor volume in proximal ileum

(5) mesentery configuration

(6) obstruction of bowel segments by tumor

 

Obstruction of Bowel Segments by Tumor

Tumor Nodule Diameter > 0.5 cm on Small Bowel Surfaces Other Than Terminal Ileum

Percent with Complete Resection

Percent with Incomplete Resection

N

N

94%

6%

N

Y

64%

36%

Y

N

25%

75%

Y

Y

8%

92%

 

Survival:

• Patients with a complete resection of tumor had a 100% 5 year survival.

• Patients with incomplete resection of tumor had a 45% 5 year survival.

 


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