The role of miR-765 in human cancers.

MicroRNAs, a collection of short noncoding RNAs, are promising biomarkers for identifying cancer in its early stages and tracking the effectiveness of treatment. This is due to their critical role in regulating gene expression and other vital biological functions via cell-level epigenetic mechanisms. This review brings together data on the molecular and clinical effects of miR-765 on different types of cancer. Significant variation in miR-765 levels has been observed in a variety of cancer types, suggesting that it could have an oncogene or tumor suppressor role. A number of pathways, including PLP2/Notch, VEGFA/Akt1, PDX1, KLK4, RUNX2, DPF3, EMP3, APE1, ERK/EMT axis, and others, are impacted by the inclusion of miR-765 in their analysis. MiR-765 is an essential biomarker that shows promise as a diagnostic tool for various types of cancer. The latest research has identified them as reliable predictive markers for detecting tumor development at an early stage. Based on our study, miR-765 shows promising potential as a biomarker for prognosis in multiple types of cancer. Specifically, we suggest that miR-765 could be an early detection marker for tumor development, progression, and metastasis.

Copper-Vit B3 MOF preparation, characterization and catalytic evaluation in a one-pot synthesis of benzoxanthenones with docking validation as anti H. pylori.

Copper-Vit B3 MOF was successfully prepared by efficient and eco hydrothermal method. The prepared MOF was characterized as a tetragonal crystal copper-MOF nanoparticles by FTIR, SEM, TEM, EDX and XRD. The prepared nanoparticles were used as an effective, inexpensive and low-toxic catalyst in the one-pot synthesis of some new benzoxanthenone derivatives. As example 4-(9,9-dimethyl-11-oxo-8,10,11,12-tetrahydro-9H-benzo[a]xanthen-12-yl)phenyl benzoate (4h) was synthesized in high yield 92%. The MOF catalyst's role is activating the nucleophilic attack by increasing the carbonyl polarization, and this generally improves the reaction time, which ranges between 20-60 minutes and products' yields ranging between 80-92%. Prepared compounds (4a-4j) undergo molecular docking scanning as Helicobacter pylori type II dehydroquinase inhibitors, and the data obtained showed that there are three promises of the prepared compounds 4d, 4e, 4h and 4j compared with amoxicillin.

Stabilization of the cubic, fast-ion conducting phase of Li7La3Sn2O12 garnet by gallium doping.

All-solid-state batteries present promising high-energy-density alternatives to conventional Li-ion chemistries, and Li-stuffed garnets based on Li7La3Zr2O12 (LLZO) remain a forerunner for candidate solid-electrolytes. One route to access fast-ion conduction in LLZO phases is to stabilize the cubic LLZO phase by doping on the Li sites with aliovalent ions such as Al3+ or Ga3+. Despite prior attempts, the stabilization of the cubic phase of isostructural Li7La3Sn2O12 (LLSO) by doping on the Li sites has up to now not been realised. Here, we report a novel cubic fast-ion conducting Li7La3Sn2O12-type phase stabilized by doping Ga3+ in place of Li. 0.3 mole of gallium per formula unit of LLSO were needed to fully stabilize the cubic garnet, allowing structural and electrochemical characterizations of the new material. A modified sol-gel synthesis approach is introduced in this study to realise Ga-doping in LLSO, which offers a viable route to preparing new Sn-based candidate solid-electrolytes for all-solid-state battery applications.

Using machine learning models to predict synchronous genitourinary cancers among gastrointestinal stromal tumor patients.

Objectives: Gastrointestinal stromal tumors (GISTs) can occur synchronously with other neoplasms, including the genitourinary (GU) system. Machine learning (ML) may be a valuable tool in predicting synchronous GU tumors in GIST patients, and thus improving prognosis. This study aims to evaluate the use of ML algorithms to predict synchronous GU tumors among GIST patients in a specialist research center in Saudi Arabia. Materials and Methods: We analyzed data from all patients with histopathologically confirmed GIST at our facility from 2003 to 2020. Patient files were reviewed for the presence of renal cell carcinoma, adrenal tumors, or other GU cancers. Three supervised ML algorithms were used: logistic regression, XGBoost Regressor, and random forests (RFs). A set of variables, including independent attributes, was entered into the models. Results: A total of 170 patients were included in the study, with 58.8% (n = 100) being male. The median age was 57 (range: 9-91) years. The majority of GISTs were gastric (60%, n = 102) with a spindle cell histology. The most common stage at diagnosis was T2 (27.6%, n = 47) and N0 (20%, n = 34). Six patients (3.5%) had synchronous GU tumors. The RF model achieved the highest accuracy with 97.1%. Conclusion: Our study suggests that the RF model is an effective tool for predicting synchronous GU tumors in GIST patients. Larger multicenter studies, utilizing more powerful algorithms such as deep learning and other artificial intelligence subsets, are necessary to further refine and improve these predictions.

Serum survivin in acne versus post-acne scarring and the possible effect of isotretinoin therapy on its level.

INTRODUCTION: Acne vulgaris is a common chronic inflammatory disorder of the pilosebaceous unit. Survivin is an apoptosis inhibitor protein, and it contributes crucially to cell cycle regulation. This study measures the serum level of survivin in acne and post-acne scarring patients, and assesses the possible effect of isotretinoin therapy on its level. METHODS: Sixty participants, including 40 acne patients (Group IA, IB), and 20 age- and sex-matched controls (Group II) were included. Group IA included 20 patients with active moderate-to-severe acne without scarring, and this group was further prescribed oral isotretinoin therapy for 3 months. Group IB included 20 patients with post-acne scarring of a duration not more than 6 months, without evident active acne lesions. Serum survivin levels were measured in the three groups using an enzyme-linked immunosorbent assay. RESULTS: There was a statistically significant higher serum survivin level in the acne scar group, followed by the active acne group, than in controls. In addition, there was a statistically significant reduction in survivin levels after treatment, and it was positively correlated with a reduction in the global acne grading system (GAGS) in the active acne group. CONCLUSIONS: Survivin may play a role in the evolution of acne and acne scarring, and it could be a possible target for isotretinoin therapy.

The association of genitourinary cancer among Saudi patients with gastrointestinal stromal tumors and a systematic literature review.

The gastrointestinal tract's most commonly occurring primary mesenchymal tumor is the gastrointestinal stromal tumor (GIST). However, few cases worldwide were reported associated with renal cell carcinoma (RCC). Therefore, we aimed to identify the association of genitourinary tumors in patients with GIST in our tertiary care hospital in Saudi Arabia and compare it to the literature. We identified all patients in the pathology department database with the diagnosis of GIST. We excluded duplicate and recurrent cases. We examined patients' files for the presence of RCC, adrenal tumors, or other genitourinary cancer. A systematic review of the association was conducted. From 2003 to 2020, 170 patients had a histopathologic diagnosis of primary GIST, 100 men and 70 women, median age of 57 (range 9-91) years at the time of diagnosis. The site of primary GIST was gastric 103, small bowel 43, mesenteric 5, omentum/peritoneum 7, abdomen 4, isolated adrenal 1, and other 7. Six patients had associated primary genitourinary cancer. Three patients had RCC (two clear cell RCC and one radiologic diagnosis only), and three had adrenal tumors (one adrenal carcinoma, one an isolated adrenal GIST, and one pheochromocytoma). In addition, two patients had a tumor invading the urinary bladder. Although the cohort included 63 men aged 60 or above (median 71 ± 8.7 years, range 60-94), none demonstrated clinical prostatic carcinoma. Data was compared to 69 systematic review articles. We report the rare association between GIST tumors and primary genitourinary cancer, mainly RCC and adrenal tumors. Also, we identified a secondary invasion of the urinary bladder. Unlike the reported series, none of the older male patients had clinical prostate cancer.

The Use of Intraoperative Radiation Therapy (IORT) in Multimodality Management of Cancer Patients: a Single Institution Experience.

BACKGROUND: Intraoperative radiation therapy (IORT) is a highly conformal type of radiation therapy given at time of surgery aiming for better tumor local control. It increases the tumor radiation dose without exceeding normal tissues tolerance doses. PURPOSE: To assess the feasibility of IORT and short-term toxicities in patients with different cancer sites treated with multidisciplinary protocol including IORT. PATIENTS AND METHODS: Medical records of cancer patients who received IORT as a part of their multidisciplinary treatment at King Faisal Specialized Hospital and Research center (KFSH&RC), Riyadh, Saudi Arabia, from January 2013 until December 2017 were retrospectively reviewed. RESULTS: A total of 188 patients with 210 IORT applications were analyzed. Twenty-two patients had two applications at the same time. One hundred sixteen patients were males. Median age at time of diagnosis was 49.5 years (19-77). One hundred thirty-four patients had primary, while 54 cases had recurrent disease. Gastroesophageal cancer and soft tissue sarcoma were the most frequent diagnosis in 49 patients followed by colorectal cancer in 35 patients. Major surgeries with curative intent done in 183 patients (97.3%). Hyperthermic intraperitoneal chemotherapy (HIPEC) was performed in 118 (62.8%) patients. The 30-day postoperative mortality rate was 3.2%. Fifty-four (28.7%) patients develop grades III-IV complications according to Clavien-Dindo grading system. CONCLUSION: The data presented discusses using of IORT treatment for different malignant tumors as a part of multimodality treatment. IORT seems safe and feasible; however, a longer follow-up period is needed for proper evaluation and to define the role of IORT in a tailored multimodality approach.

Almost unbiased modified ridge-type estimator: An application to tourism sector data in Egypt.

This paper introduces an almost unbiased modified ridge-type estimator (AUMRTE) to avoid problems arising from multicollinearity. This estimator has the important features of the two important shrinkage estimators, the modified ridge-type estimator (MRTE) and almost unbiased estimator (AUE). We investigated the theoretical excellence of the proposed estimator according to the mean square error (MSE). We found that it has the superiority than the (MRTE) and almost unbiased two-parameter estimator (AUTE). Moreover, we run the simulation study, which depended on the simulated MSE (SMSE), squared bias (SB) and generalized cross-validation (GCV) as criteria to compare the estimators. The simulation results showed that the proposed estimator has the superiority than the estimators under comparison at several factors and at the same time, it works well at the high level of correlation. In addition, we investigated the behavior of the present estimator applying the real data. Under this trend, we applied the estimator to the tourism sector data in Egypt, which the results were consistent with the theoretical results.

New Method to Implement and Analysis of Medical System in Real Time.

The use of information technology and technological medical devices has contributed significantly to the transformation of healthcare. Despite that, many problems have arisen in diagnosing or predicting diseases, either as a result of human errors or lack of accuracy of measurements. Therefore, this paper aims to provide an integrated health monitoring system to measure vital parameters and diagnose or predict disease. Through this work, the percentage of various gases in the blood through breathing is determined, vital parameters are measured and their effect on feelings is analyzed. A supervised learning model is configured to predict and diagnose based on biometric measurements. All results were compared with the results of the Omron device as a reference device. The results proved that the proposed design overcame many problems as it contributed to expanding the database of vital parameters and providing analysis on the effect of emotions on vital indicators. The accuracy of the measurements also reached 98.8% and the accuracy of diagnosing COVID-19 was 64%. The work also presents a user interface model for clinicians as well as for smartphones using the Internet of things.

Core shell stationary phase for a novel separation of some COVID-19 used drugs by UPLC-MS/MS Method: Study of grapefruit consumption impact on their pharmacokinetics in rats.

A sensitive and selective UPLC-MS/MS method was developed for the synchronized determination of four drugs used in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), namely, azithromycin, apixaban, dexamethasone, and favipiravir in rat plasma. using a Poroshell 120 EC-C18 column (50 mm × 4.6 mm, 2.7 m) with a high-resolution ESI tandem mass spectrometer detection with multiple reaction monitoring. We used an Agilent Poroshell column, which is characterized by a stationary phase based on non-porous core particles. With a remarkable improvement in the number of theoretical plates and low column backpressure. In addition, the developed method was employed in studying the potential food-drug interaction of grapefruit juice (GFJ) with the selected drugs which affects their pharmacokinetics in rats. The LC-MS/MS operated in positive and negative ionization mode using two internal standards: moxifloxacin and chlorthalidone, respectively. Liquid- liquid extraction of the cited drugs from rat plasma was accomplished using diethyl ether: dichloromethane (70:30, v/v). The analytes were separated using methanol: 0.1 % formic acid in water (95: 5, v/v) as a mobile phase in isocratic mode of elution pumped at a flow rate of 0.3 mL/min. A detailed validation of the bio-analytical method was performed in accordance with US-FDA and EMA guidelines. Concerning the in vivo pharmacokinetic study, the statistical significance between the results of the test groups receiving GFJ along with the cited drugs and the control group was assessed demonstrating that GFJ increased the plasma concentration of azithromycin, apixaban, and dexamethasone. Accordingly, this food-drug interaction requires cautious ingestion of GFJ in patients using (SARS-CoV-2) medications as it can produce negative effects in the safety of the drug therapy. A potential drug-drug interaction is also suggested between those medications requiring a suitable dose adjustment.

Quantitative Evaluation of Palatal Lengthening After Cleft Palate Repair When a Buccal Flap Is Routinely Combined With Furlow's Z-Plasty.

INTRODUCTION: The use of a buccinator myomucosal flap in combination with Furlow's Z-plasty during primary and secondary palatal repairs has been proposed by many authors to overcome some of the limitations of Furlow's technique. However, there have been no studies that quantitatively measured the effective palatal lengthening when the buccal flap is added. PATIENTS AND METHODS: The buccal flap is routinely used during primary palate repair in order to fill the gap between the hard palate and reoriented palatal muscle sling. The soft palatal length was measured in the midline from the posterior edge of the hard palate to the base of the uvula. All patients were measured before starting the surgery and just after palatal closure in the standard position for cleft palate repair. RESULTS: Seventy-three patients with cleft palate who were candidates for primary repair were included. The mean age at the time of operation was 11.4 ± 3.5 months. The mean preoperative palatal length was 21.36 ± 3.529 mm, whereas the mean postoperative palatal length was 29.64 ± 4.171) mm. The mean palatal length change was 8.29 ± 2.514 mm (P < 0.000). CONCLUSIONS: The Combined use of a buccinator myomucosal flap with modified Furlow's Z-plasty in primary cleft palate repair has proven effective for palatal lengthening and achieved tensionless closure without the need for relaxing incision. It also provided a pliable soft tissue attachment of the palatal muscles to the hard palate allowing for better muscle function and mobility.

Photodynamic therapy using methylene blue and intense pulsed light versus intense pulsed light alone in treatment of verruca: A randomized controlled study.

BACKGROUND: Many therapeutic modalities are available for treatment of warts, but no single therapy is universally effective. Photodynamic therapy (PDT) using intralesional methylene blue (MB) followed by intense pulsed light (IPL) could be a successful option for treatment by several mechanisms. METHODS: This prospective randomized controlled trial was carried out on eighty patients with verrucae. Patients were randomized into three groups; group A (30 patients) received MB/IPL/PDT sessions, group B (30 Patients) received IPL sessions, and group C (control). Response was assessed by clinical and dermoscopy score (0,1, 2, or 3 according to extent of clinical and dermoscopic resolution), cure rate (percent of verrucae clinically and dermoscopy cleared), and imageJ analysis (surface area of wart and haemorrhagic structures or vessels). RESULTS: Clinical and dermoscopic clearance was achieved in 43.3% and 20% of patients in groups A and B respectively. Cure rate was 40.9% for group A compared to 23.4% for group B. ImageJ analysis revealed more reduction of surface area in group A being 80.05 ± 27.12% for verrucae and 89.28 ± 19.19% for vessels and haemorrhagic dots compared to 48.16 ± 34.21% and 65.99 ± 30.58% in group B. CONCLUSIONS: MB/IPL/PDT is an effective option for treatment of warts with a success rate of around 40%, based on clinical and dermoscopic assessment. The efficacy was found to be higher on using imageJ utilizing both the surface area of the wart and surface area of vessels and haemorrhagic dots with the latter being more effected by treatment.

Synthesis, photocatalytic and antidiabetic properties of ZnO/PVA nanoparticles.

A series of ZnO and ZnO/poly(vinyl alcohol) (PVA) catalysts were prepared using sol-gel method. An X-ray diffraction analysis confirmed the existence of the wurtzite ZnO phase, and scanning electron microscopy (SEM) observation revealed the formation of spherical ZnO and ZnO/PVA nanoparticles. The decomposition of methylene blue (MB) and methyl orange (MO) induced by the synthesized pure ZnO and ZnO/PVA nanoparticles was studied under ultraviolet-visible irradiation. Among the catalysts evaluated, ZnO/5PVA was the most active in the decomposition of MB, whereas ZnO/7PVA was the most active catalyst in the decomposition of MO. Moreover, an investigation of the biological activity of pure ZnO and ZnO/PVA indicated that ZnO/5PVA exhibited the best performance in lowering the glucose level in diabetic rats.

Mucinous Appendiceal Adenocarcinoma Penetrated the Quadratus Lumborum Muscle Posteriorly and Presented as Gluteal Abscess Managed Aggressively with Drainage Followed by Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy Combined with Intraoperative Radiotherapy. a Case Report and Review of the Literature.

Appendiceal mucinous adenocarcinoma is a term that was given for invasive appendiceal tumors. It is always present with pseudomyxoma peritonei which is a complex disease. These tumors have the tendency to surround the primary tumor then extend primarily and extensively all over the peritoneal cavity as the primary site of metastases. The invasion through the abdominal wall muscles is rare but the penetration and passing through these muscles to the subcutaneous tissue are extremely rare. A 62-year-old male patient known to have pseudomyxoma peritonei presented with gluteal abscess. After 2 weeks from the abscess drainage, the patient underwent cytoreductive surgery (CRS) combined with intraoperative radiotherapy (IORT) and hyperthermic intraperitoneal chemotherapy (HIPEC). He tolerated the operation well and discharged home in a good condition. Even with extensive appendiceal mucinous neoplasms presented with the penetration of the abdominal wall muscles, still aggressive management should be considered.

Combined Intraoperative Radiotherapy (IORT) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) with Cytoreduction Surgery (CRS) as a Novel Approach in the Management of Resectable Pancreatic Cancer.

BACKGROUND: Pancreatic cancer is leading cause of cancer related deaths. The prognosis is usually very poor. In spite of the advances in modern surgery, the outcome is still poor. IORT was recently introduced with recorded improvement in both locoregional tumor control and patient survival. Prophylactic HIPEC was introduced during the initial surgery in order to prevent subsequent peritoneal cancer or tumor recurrence which showed some encouraging results. AIM OF WORK: Evaluation of the perioperative results of the combination of IORT and HIPEC with CRS as a novel approach in the management of resectable pancreatic cancer. PATIENTS AND METHODS: This study was conducted at King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia. Data were collected retrospectively. A total of five patients were included in the study, during the period from November 2017 to August 2018. All surgeries were done by the same surgeon. RESULTS: The average age was 51 years (25-63). The patients were two males and three females. All the patients underwent complete surgical resection combined with IORT then HIPEC. All patients were discharged home in good condition. They were regularly followed up without any evidence of local recurrence or metastases. CONCLUSION: The combination of IORT and HIPEC with CRS gives the addition of the benefits of each procedure alone without affecting the postoperative morbidity or mortality. This combination appeared to be feasible, safe and well tolerated. However, this need to be applied on a larger number of patients with longer periods of follow-up to reach sound conclusions.

Acute abdomen caused by rupture of a torted intra-abdominal testicular mass: Case report.

INTRODUCTION: Cryptorchidism is defined as the absence of one or both testicles from the scrotum, which is considered one of the most common birth defects of male genitalia. Mostly the undescended testes are in the inguinal region, while the intra-abdominal location accounts for only 10 % of the cases. The potential risk of malignant transformation in an undescended testis is approximately 2.5-8 times higher than in scrotal position. Torsion of the cryptorchid testis is a very rare cause of acute abdominal pain with few cases published in literature. CASE PRESENTATION: A 44-year-old male patient presented to the emergency room with acute abdominal pain. General examination revealed relevant tachycardia. Upon abdominal examination there was tenderness and rebound tenderness all over the abdomen, more evident in the lower abdomen. Interestingly, routine examination of the inguino-scrotal region revealed empty right hemi-scrotum despite the patient not being aware. Routine blood tests showed marked anemia Hb: 7.4 g/dl. Urgent pelvi-abdominal U/S showed moderate free intra-abdominal collection in addition to a pelvic mass. CT of the abdomen showed a well-defined heterogenous hypodense mass measuring about 8.5 × 5.5 cm in the pelvis. Urgent exploratory laparotomy was done, and a mass was found to be torted and ruptured. Excision was done and histo-pathological examination revealed testicular mixed germ cell tumor. CONCLUSION: Undescended testis is associated with an increased risk of infertility, testicular cancer and torsion. In any male with undescended testis and intra-abdominal mass; the risk of intra-abdominal testicular tumor should be considered.

Noncultured Extracted Hair Follicle Outer Root Sheath Cell Suspension versus Noncultured Epidermal Cell Suspension in the Treatment of Stable Vitiligo.

BACKGROUND: Various treatment modalities exist for vitiligo, yet none of them are curative. Vitiligo is still considered a challenging disease to manage. Surgical treatment offers an excellent option for patients with stable vitiligo, especially those who fail to respond to medical treatment. Cell suspension techniques carry the advantage of covering large surface areas. OBJECTIVE: To compare noncultured extracted hair follicle outer root sheath cell suspension (NCORSHFS) and noncultured epidermal cell suspension (NCES) in producing repigmentation. SUBJECTS AND METHODS: Twenty patients were randomly allocated into two groups. They were objectively evaluated for the extent of repigmentation (after 1, 2, and 3 months), complications, cosmetic outcome, and satisfaction. RESULTS: In NCORSHFS group, 10% showed excellent pigmentation, 20% showed good pigmentation, 50% fair, and 20% poor pigmentation. In NCES group, 10% showed excellent pigmentation, 10% good pigmentation, 40% fair, and 40% poor pigmentation. This difference was not statistically significant. Excellent color match was observed in 80% of NCORSHFS and in 70% of NCES. Donor area complications were absent in NCORSHFS group, whereas in NCES, mild scarring in 20% and hyperpigmentation in 40% of patients was observed. The difference in patients' satisfaction between the two groups was not statistically significant. CONCLUSION: Both NCORSHFS and NCES are effective in producing good repigmentation with perfect color match and patients' satisfaction. NCORSHFS has no donor area complications because it is a scarless procedure.

A validated RP-HPLC method for the evaluation of the influence of grapefruit juice on liver S9 activation of sacubitril.

Grapefruit juice inhibits esterase enzyme. Therefore, a possible interaction with ester prodrugs should be taken into consideration. In this study, the influence of grapefruit juice on sacubitril (SAC) rat liver S9 activation by esterase enzyme was evaluated. An RP-HPLC method was developed and validated for estimation of SAC in rat liver S9 fraction using a C18 Cyano column as stationary phase and acetonitrile-sodium di-hydrogen phosphate buffer (0.02 m, pH 4 adjusted by o-phosphoric acid, 40:60, v/v), as mobile phase at a flow rate of 1 mL/min and UV detection at 254 nm. The method was successfully applied to an in vitro study in which SAC was incubated with rat liver S9 fraction prepared from rats that had previously ingested grapefruit juice for a week. The calculated SAC concentration after incubation was compared with that of SAC incubated with rat liver S9 fraction from the rat control group. The statistical significance between the results of test and control incubation sets was assessed. In conclusion, the current study demonstrated that grapefruit juice decreased SAC hydrolysis, hence delaying its activation to sacubitrilat (active form) in gut lumen. Based on this food-drug interaction, it may be required that grapefruit juice should be consumed with caution in patients receiving SAC.

Right Temporal Brain Metastases Arising Three Years after Curative Resection of Gastric Cancer: A Case Report.

BACKGROUND: Gastric cancer can metastasize to multiple organs but the metastases to brain is very rare. We report a case of recurrent gastric cancer. The only site of recurrence is brain metastases that occurred three years after curative resection. CASE PRESENTATION: A 58-year-old male patient who was diagnosed to have gastric cancer. He received neoadjuvant chemotherapy then complete resection. The patient came to the outpatient clinic for regular follow up. After three years from resection the patient complained of headache and seizures. CT scan brain showed right temporal bone localized tumor. Complete resection was done which revealed it is a localized metastases from gastric cancer. CONCLUSION: Localized brain metastases from gastric cancer is a rare event. Urgent CT scan must be done if the patient had any neurological complaint. Early diagnosis is the key for the patient management. Rapid treatment can improve the patient general condition and neurological manifestations.

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the management of pseudomyxoma peritonei: A single-center experience.

BACKGROUND AND AIMS: Pseudomyxoma peritonei (PMP) results from perforated appendiceal tumors. It is usually diagnosed preoperatively by imaging. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), although aggressive long procedure with high complications rate, was considered the optimal treatment. This study is aiming to study the role of CRS and HIPEC in the management of PMP and assess the outcome. METHODS: This is a retrospective study which was conducted at King Faisal Hospital and Research Center, a tertiary care hospital during the period from November 2008 to June 2016. Approval of the Research Advisory Council was obtained. Forty-one procedures of CRS and HIPEC were performed in 38 patients. Using the open abdomen technique, CRS was performed using standard peritonectomy procedures and visceral resections directed toward the complete elimination of tumors from abdominopelvic cavity. HIPEC was performed using mitomycin C in a dose of 30 mg/m2 and allowed to circulate in abdominopelvic cavity for 90 min at 41.0 to 42.2 °C. RESULTS: Forty-one procedures were performed in 38 patients. Three procedures were done as repeat CRS and HIPEC. No perioperative mortality. Cystoscopy and bilateral ureteric stents in 35 procedures (85.5%). Hospital stay (range 9-85 days) average is 21 days. Follow up period is 1-84 months, and median follow up is 54 months. Five-year survival rate is 92%. Median 5-year disease-free survival rate is 60%. Two patients died during the follow up period by septic shock and one patient died from disease progression. CONCLUSION: CRS and HIPEC is well-tolerated and feasible management for PMP.