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Br J Surg. 2018 May;105(6):668-676. doi: 10.1002/bjs.10716. Epub 2018 Feb 7.

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for pseudomyxoma peritonei of appendicular and extra-appendicular origin.

Author information

1
Department of General and Digestive Surgery, Hautepierre Hospital, Strasbourg University Hospital, Strasbourg, France.
2
Department of Public Health, Strasbourg University Hospital, Strasbourg, France.
3
Department of Pathology, Hautepierre Hospital, Strasbourg University Hospital, Strasbourg, France.
4
Department of General and Oncological Surgery, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France.
5
Department of Surgical Oncology, Alexis Vautrin Lorraine Institute of Oncology, Université de Lorraine, Vandoeuvre-lès-Nancy, France.
6
Surgical Oncology and Digestive Unit, Lariboisière University Hospital, Paris, France.
7
Department of Surgical Oncology, Montpellier Cancer Centre, Montpellier, France.
8
Department of Surgical Oncology, Claudius Regaud Institute, Toulouse, France.
9
Department of Surgical Oncology, Gustave Roussy Cancer Campus, Villejuif Cedex, France.

Abstract

BACKGROUND:

The prognostic value of the primary neoplasm responsible for pseudomyxoma peritonei (PMP) remains poorly studied. The aim of this study was to determine the prognosis for patients with extra-appendicular PMP (EA-PMP) treated optimally with complete cytoreductive surgery (CCRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).

METHODS:

All patients treated for PMP with CCRS and HIPEC between 1994 and 2016 were selected retrospectively from a French multicentre database. Patients with EA-PMP had pathologically confirmed non-neoplastic appendices and were matched in a 1 : 4 ratio with patients treated for appendicular PMP (A-PMP), based on a propensity score.

RESULTS:

Some 726 patients were identified, of which 61 (EA-PMP group) were matched with 244 patients (A-PMP group). The origins of primary tumours in the EA-PMP group included the ovary (45 patients), colon (4), urachus (4), small bowel (1), pancreas (1) and unknown (6). The median peritoneal carcinomatosis index was comparable in EA-PMP and A-PMP groups (15·5 versus 18 respectively; P = 0·315). In-hospital mortality (3 versus 2·9 per cent; P = 1·000) and major morbidity 26 versus 25·0 per cent; P = 0·869) were also similar between the two groups. Median follow-up was 66·9 months. The 5-year overall survival rate was 87·8 (95 per cent c.i. 83·2 to 92·5) per cent in the A-PMP group and 87 (77 to 96) per cent in the EA-PMP group. The 5-year disease-free survival rate was 66·0 (58·7 to 73·4) per cent and 70 (53 to 83) per cent respectively.

CONCLUSION:

Overall and disease-free survival following treatment with CCRS and HIPEC is similar in patients with pseudomyxoma peritonei of appendicular or extra-appendicular origin.

PMID:
29412465
DOI:
10.1002/bjs.10716
[Indexed for MEDLINE]

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