Appendix cancer has often spread to
surfaces of the abdomen by the time it is discovered. The surgery
to remove as much of the cancer in the abdomen as possible, reducing the "bulk"
of the cancer is called "debulking" or "cytoreduction" surgery. "Cyto"
is a word root meaning cells, so cytoreduction means to
surgically "reduce" number of cancer cells. Both terms mean
the same thing and are usually used interchangeably.
surgery is often long and
complicated and is associated with a high rate of post-operative complications.
Parts of the large and small bowel along with organs or parts of organs in the
abdomen that are cancerous may
need to be removed during this surgery. "Complete cytoreduction"
or "complete debulking" means
that all of the visible tumors are successfully removed during surgery. "Incomplete cytoreduction" or "incomplete
debulking" means that all of the
tumors could not be removed during the surgery and that visible tumors were left
The factor most associated with long term survival
is completeness of cytoreduction, or the removal of all visible tumors. Cytoreduction (debulking) surgery is best
done by a surgical oncologist who specializes in these types of surgeries.
A list of some of the specialists can be found on this page:
Facilities Treating Appendix Cancer.
If all of the tumors cannot
be removed, there is less likely hood of survival unless the tumors left behind
are very small (less than 2.5mm or about 1/8th of an inch). To destroy
very small tumors and cancer cells left behind that are too small
to be seen, and to prevent them from later growing into new cancerous tumors in
the abdomen, the surgery can be followed by treatment with
Intraperitoneal Chemotherapy (HIPEC)
or by treatment with early post-operative intraperitoneal
chemotherapy (EPIC) at facilities that have the capability to provide these
treatments. These chemotherapy treatments may be effective on very
tiny tumors that cannot be removed, but are not able to completely
destroy larger tumors left behind.
Debulking surgeries can take 12 hours or more and require very large incisions. MOAS
is a nickname given to the surgery by a patient who had the procedure done and named it
the "Mother Of All Surgeries", and the acronym stuck in some
For more information about post-operative
Complications of Cytoreduction Surgery and HIPEC.
Cytoreduction (debulking) surgeries
are also done for other cancers that have spread to the peritoneal surfaces of
the abdomen such as ovarian, colon, gastric and pancreatic cancers.
to a video of cytoreduction surgery and hyperthermic intraperitoneal
chemotherapy (HIPEC) performed at Wake Forest University Baptist Medical Center in North
Carolina by Drs. Levine, Shen and Stewart:
Peritoneal Chemotherapy for Persistent Cancer in Live Internet Broadcast
If you want to know what
questions to ask your surgeon, the US Department of Health and Human Services
offers a suggested list of questions in a brochure entitled:
Making Sure Your Surgery is Safe
Hyperthermic Oncology: Cytoreductive Surgery and Intraperitoneal Hyperthermic
Indications for cytoreductive surgery and intraperitoneal chemotherapy
Appendiceal neoplasms with peritoneal dissemination: outcomes after
cytoreductive surgery an intraperitoneal hyperthermic chemotherapy.
Cytoreductive Surgery Combined With Perioperative Intraperitoneal Chemotherapy
for the Management of Peritoneal Carcinomatosis From Colorectal Cancer: A
Long-term survivorship and quality of life after cytoreductive surgery plus
intraperitoneal hyperthermic chemotherapy for peritoneal carcinomatosis.
Right hemicolectomy does not confer a survival advantage in patients with
mucinous carcinoma of the appendix and peritoneal seeding.
surgery and peri-operative intraperitoneal chemotherapy as a curative approach
to pseudomyxoma peritonei syndrome.
Surgical Debulking and Intraperitoneal Chemotherapy for Established Peritoneal
Metastases From Colon and Appendix Cancer
Reduced Morbidity Following Cytoreductive Surgery and Intraperitoneal
Heated chemotherapy prolongs survival in abdominal cancer
It's What the
Surgeon doesn't See that Kills the Patient
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informational and educational purposes only. Readers are encouraged to confirm
the information contained herein with other sources. The information on this
website is not complete and not intended to replace medical advice offered by
physicians or health care providers. Patients and consumers should review
the information carefully with their professional health care provider.
Copyright © 2005- 2010 C. Langlie-Lesnik RN
BSN All rights Reserved
02/12/2010 12:50:09 PM