Pleura and peritoneum · 2025
Proposed strategy after complete LAMN (low-grade appendiceal mucinous neoplasm) resection by different RENAPE units: need for a new consensus?
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Mouawad Christian, Taibi Abdelkader, Sgarbura Olivia, Djelil Dahbia, Marchal Frédéric, Sourrouille Isabelle, Goere Diane, Glehen Olivier, Ferron Gwenael, Dumont Fréderic, Courvoisier Clement Thomas, Brigand Cécile, Amroun Koceila Lamine, Abboud Karine, Villeneuve Laurent, Pocard Marc, RENAPE Group
Аннотация
OBJECTIVES: To evaluate current postoperative management strategies for incidentally discovered, completely resected low-grade appendiceal mucinous neoplasms (LAMNs) within the French RENAPE network and to assess the need for a new national consensus.
METHODS: A national survey was conducted among RENAPE expert centers using a structured questionnaire based on standardized postoperative risk scenarios. Survey items addressed surveillance strategies, indications for reoperation, and use of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC).
RESULTS: Ninety-one percent of centers responded. All reported systematic multidisciplinary discussion, centralized pathology and imaging review, standardized imaging, and tumor marker assessment. Marked heterogeneity was observed. For low-risk patients (R0 resection, no perforation, no extra-appendiceal mucin), 50 % recommended no follow-up and 50 % proposed long-term MRI surveillance. In intermediate-risk cases (limited perforation or adjacent mucin), 80 % favored MRI follow-up, while 20 % recommended diagnostic laparoscopy or prophylactic CRS-HIPEC. In high-risk scenarios with radiologic suspicion of implants, 60% proposed early CRS-HIPEC, whereas others preferred laparoscopic assessment or surveillance.
CONCLUSIONS: This survey highlights wide variation in postoperative strategies for LAMNs within RENAPE, especially in intermediate-risk cases. While consensus exists on centralized review and imaging, significant evidence gaps persist regarding prophylactic HIPEC. These findings underscore the need for harmonized, evidence-based protocols and prospective data collection.
METHODS: A national survey was conducted among RENAPE expert centers using a structured questionnaire based on standardized postoperative risk scenarios. Survey items addressed surveillance strategies, indications for reoperation, and use of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC).
RESULTS: Ninety-one percent of centers responded. All reported systematic multidisciplinary discussion, centralized pathology and imaging review, standardized imaging, and tumor marker assessment. Marked heterogeneity was observed. For low-risk patients (R0 resection, no perforation, no extra-appendiceal mucin), 50 % recommended no follow-up and 50 % proposed long-term MRI surveillance. In intermediate-risk cases (limited perforation or adjacent mucin), 80 % favored MRI follow-up, while 20 % recommended diagnostic laparoscopy or prophylactic CRS-HIPEC. In high-risk scenarios with radiologic suspicion of implants, 60% proposed early CRS-HIPEC, whereas others preferred laparoscopic assessment or surveillance.
CONCLUSIONS: This survey highlights wide variation in postoperative strategies for LAMNs within RENAPE, especially in intermediate-risk cases. While consensus exists on centralized review and imaging, significant evidence gaps persist regarding prophylactic HIPEC. These findings underscore the need for harmonized, evidence-based protocols and prospective data collection.