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Indian J Surg Oncol. 2019 Feb;10(Suppl 1):65-70. doi: 10.1007/s13193-018-00870-w. Epub 2019 Jan 11.

Analysis of Clinical Outcomes of Pseudomyxoma Peritonei from Appendicular Origin Following Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy-A Retrospective Study from INDEPSO.

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1Department of Surgical Oncology, Jehangir hospital, 32, Sassoon Road, Pune, Maharashtra 411001 India.
2Department of Peritoneal Surface Oncology, Saifee Hospital, Mumbai, India.
3Department of Surgical Oncology, Cancer Institute (WIA), Chennai, India.
Department of Surgical Oncology, MVR Cancer Center and Research Institute, Calicut, India.
5Department of Surgical Oncology, All India Institute of Medical Sciences, New Delhi, India.
6Department of Surgical Oncology, Manipal Hospital, Bangalore, India.
Department of Surgical Oncology, Zydus Hospital, Ahmedabad, India.


To evaluate the clinical outcomes of patients of pseudomyxoma peritonei of appendiceal origin undergoing cytoreductive surgery and HIPEC. Data collected from members, an independent collaborative group of Indian surgeons specializing in the management of peritoneal surface malignancy (INDEPSO), was analyzed retrospectively. Clinicopathological and perioperative outcomes of patients treated for pseudomyxoma peritonei (PMP) of appendicular origin were evaluated. Ninety-one patients were diagnosed with pseudomyxoma peritonei of appendicular origin between March 2013 and December 2017. The median age was 53 years and 60% were females. The median PCI was 27 [range 3-39] and a CC-0/1 resection was achieved in 83.5% patients. The most common histological grade was low-grade PMP, seen in 71.4% cases. The overall rate of grades 3-4 morbidity was 33% (30/91) and the 90-day mortality rate reported was 6.5%. Pulmonary complications and systemic sepsis emerged as the most significant factors affecting morbidity, mortality, and failure to rescue. At a median follow-up of 24 months, the median OS was not reached and the median PFS was 53 months. On univariate and multivariate analysis, high-grade histology, prior chemotherapy, debulking surgery alone without HIPEC, and high PCI > 10 were predictors of poor progression-free survival. The survival and morbidity results of pseudomyxoma peritonei from appendicular origin following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy are encouraging. With further awareness and understanding of the disease, and improvement in surgical expertise and learning curve, there is scope for further reduction in morbidity and better improvement in survival.


Appendiceal tumor; HIPEC; Pseudomyxoma peritonei

[Available on 2020-02-01]

Conflict of interest statement

Compliance with Ethical StandardsThe authors declare that they have no conflict of interest.

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