Patient
Age (years)
Histology
Stage
Surgery
Radiotherapy
Adjuvant chemotherapy
Pt 1
58
IDC
T2 N1
Radical mastectomy
No
CMF
Pt 2
54
ILC
T2N3
Quadrantectomy
Yes
Refused
Pt 3
55
ILC
T2 N1 M1 (bone)
Radical mastectomy
No
CMF
Pt 4
77
IDC
T2 N1
Radical mastectomy
No
Refused
Pt 5
53
IDC
T1 N0
Radical mastectomy
No
None
Pt 6
70
ILC
T2N1
Radical mastectomy
Yes
CMF+ H-Th
Pt 7
63
ILC
T2 N0
Radical mastectomy
No
H-Th
Table 9.2
Immunohistochemical panel findings in the seven patients at primary diagnosis and at peritoneal relapse
Patient | BRCA carrier Status | ER PR HER-2 | WT1 | GCDFP-15 | CK7 CK20 Ca-125 | ||||
|---|---|---|---|---|---|---|---|---|---|
Primary | Relapse | Primary | Relapse | Primary | Relapse | Primary | Relapse | ||
Pt 1 | Neg | + | +++ | Neg | Neg | Neg | + | Pos | Pos |
+ | Neg | Neg | Neg | ||||||
Neg | Neg | Pos | Neg | ||||||
Pt 2 | Neg | + | + | Neg | Neg | Neg | + | Pos | Pos |
Neg | Neg | Pos | Neg | ||||||
+ | ++ | Neg | Neg | ||||||
Pt 3 | Neg | + | ++ | Neg | Neg | Neg | ++ | Pos | Pos |
Neg | Neg | Neg | Neg | ||||||
Neg | ++ | Pos | Neg | ||||||
Pt 4 | Neg | Neg | Neg | Neg | Neg | Neg | ++ | Pos | Pos |
Neg | Neg | Neg | Neg | ||||||
Neg | Neg | Neg | Neg | ||||||
Pt 5 | Neg | Neg | ++ | Neg | Neg | Neg | +++ | Pos | Pos |
Neg | + | Neg | Neg | ||||||
Neg | Neg | Neg | Neg | ||||||
Pt 6 | Neg | ++ | ++ | Neg | Neg | Neg | ++ | Pos | Pos |
+ | + | Neg | Neg | ||||||
+ | + | Neg | Neg | ||||||
Pt 7 | Neg | +++ | ++ | Neg | Neg | Neg | +++ | Pos | Pos |
+++ | ++ | Pos | Pos | ||||||
Neg | Neg | Neg | Neg | ||||||
None of the patients were breast cancer gene (BRCA) mutation carriers, and all patients’ tumors tested negative for WT1 and Ca-125 and positive for GCDFP-15. Surgical-related morbidity and mortality are shown in Table 9.3. After receiving HIPEC, one patient experienced a transient grade II cisplatin renal toxicity reversed by medical treatment and one patient a moderate pancreatitis requiring medical treatment. The mean PCI was 19 (range 15–24). Long-term survival is reported in Table 9.4. Of the seven patients, four are presently alive and disease-free at 11, 58, 117, and 135 months.
Table 9.3
Perioperative data
Patient | Postoperative stay (days) | Length of procedure (min) | Blood loss (cc) | ICU stay (h) | Morbidity (grade, type) Clavien-Dindo [20] |
|---|---|---|---|---|---|
Pt 1 | 16 | 220 | 1,300 | 18 | II, wound infection |
Pt 2 | 24 | 230 | 2,000 | 18 | − |
Pt 3 | 20 | 200 | 1,100 | 12 | IVa, TIA |
Pt 4 | 21 | 210 | 1,400 | 24 | II, pleural effusion, wound infection |
Pt 5 | 11 | 190 | 600 | 12 | − |
Pt 6 | 14 | 200 | 700 | 15 | III-b, anastomotic leakage |
Pt 7 | 13 | 180 | 400 | 17 | II, anemia |
Mean | 17.0 | 205 | 1,100 | 16.6 | − |
Table 9.4
Cytoreduction and HIPEC in patients with PM from BC – survival and QOL
Patient | Years after breast cancer | Surgery | PCI | CC | Survival (months) | QOL (3 months) |
|---|---|---|---|---|---|---|
Pt 1 | 11 | PP + total colectomy greater omentectomy | 15 | 0 | Alive DF, 135 | 8.1 |
Pt 2 | 30 | PP + small bowel resection, greater omentectomy, splenectomy appendectomy | 22 | 1 | Alive DF, 117 | 7.4 |
Pt 3 | 21 | PP + right colectomy, small bowel resection, greater omentectomy | 22 | 2 | Dead, 56 for disease progression | 5.3 |
Pt 4 | 14 | PP +, greater omentectomy, splenectomy, appendectomy | 24 | 1 | Dead, 63 for disease progression | 6.7 |
Pt 5 | 18 | Hysteroadnexectomy, greater omentectomy, appendectomy | 18 | 0 | Alive DF, 58 | 7.8 |
Pt 6
Related posts: Unusual Indications of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: A Review of Outcomes and Report of the Literature
Selection of Chemotherapy in Hyperthermic Intraperitoneal Chemotherapy
Peritoneal Metastasis of Retroperitoneal Tumors
 Peritoneal Metastasis from Small Bowel Adenocarcinoma Associated with Crohn’s Disease
 Benign Types of Peritoneal Mesothelioma
 Treatment of Pseudomyxoma Peritonei from Non-appendiceal Primary Sites
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