Pseudomyxoma peritonei: a French multicentric study of 301 patients treated with cytoreductive surgery and intraperitoneal chemotherapy. Eur J Surg Oncol 36:456

Department of Oncologic Surgery, Institut Gustave Roussy, 39 Rue Camille Desmoulins, 94805 Villejuif Cédex, France.
European journal of surgical oncology: the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology (Impact Factor: 3.01). 03/2010; 36(5):456-62. DOI: 10.1016/j.ejso.2010.01.006
Source: PubMed


To analyze a large series of patients with pseudomyxoma peritonei (PMP) treated with cytoreductive surgery associated with perioperative intraperitoneal chemotherapy (PIC) in 18 French-speaking centers.
From March 1993 to December 2007, 301 patients with diffuse PMP were treated by cytoreductive surgery with PIC. Complete cytoreductive surgery was achieved in 219 patients (73%), and hyperthermic intraperitoneal chemotherapy (HIPEC) was performed in 255 (85%), mainly during the latter period of the study.
Postoperative mortality and morbidity were 4.4% and 40%, respectively. The mean follow-up was 88 months. The 5-year overall and disease-free survival rates were 73% and 56%, respectively. The multivariate analysis identified 5 prognostic factors: the extent of peritoneal seeding (p=0.004), the center (p=0.0004), the pathologic grade (p=0.03), gender (p=0.02), and the use of HIPEC (p=0.04). When only the 206 patients with complete cytoreductive surgery were considered, the extent of peritoneal seeding was the only significant prognostic factor (p=0.004).
This large multicentric retrospective study confirms that cytoreductive surgery combined with PIC (with the use of hyperthermia) should be considered as the gold standard treatment of PMP and should be performed in specialized centers. It underlines the prognostic impact of the extent of peritoneal seeding, especially in patients treated by complete cytoreductive surgery. This prognostic impact appears to be greater than that of the pathologic grade.

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    ABSTRACT: Pseudomyxoma peritonei is usually a benign tumor that is slightly more common in women. However, it requires aggressive surgical treatment and chemotherapy, often compromising future reproductive function. This report presents a case of pregnancy in a 35-year-old woman who underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for treatment of pseudomyxoma peritonei. The tumor was diagnosed during a laparoscopic examination on a workup for infertility in 2008. Two months later, she underwent a peritonectomy followed by hyperthermic intraperitoneal chemotherapy and, regarding her will to conceive, ovaries and fallopian tubes were preserved. In March 2011, she went through an in vitro fertilization followed by an uneventful pregnancy and delivered a healthy child 39 weeks later. Ovaries are usually resected during the cytoreductive surgery, since they are common sites for neoplastic implants, and, even when not performed, little is known about the effects of local chemotherapy on female fertility. The largest international survey on this matter only describes seven similar cases. This particular report not only describes a rare condition but also adds to the upcoming discussion about whether ovaries can be preserved in specific situations, therefore keeping the prospect of conceiving after this treatment.
    06/2014; 2014:694912. DOI:10.1155/2014/694912
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    • "respectively (7). In France, a large multicentric retrospective study of 301 patients reported that the 5-year overall and disease-free survival rates were 73 and 56%, respectively (8). Furthermore, a total of 103 patients were treated at The Netherlands Cancer Institute (Amsterdam, The Netherlands), and the 3- and 5-year disease-free survival probabilities were revealed to be 43.6 and 37.4%, respectively (9). "
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    Experimental and therapeutic medicine 01/2014; 7(1):185-190. DOI:10.3892/etm.2013.1408 · 1.27 Impact Factor
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    • "HIPEC with mitomycin C followed by systemic chemotherapy resulted in a 45% 5-year survival in colorectal patients receiving complete cytoreduction [21]. In a second study the 5-year survival among 1290 patients with PC from different primary origins receiving CRS and perioperative chemotherapy was 37% [12] "
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    The Scientific World Journal 03/2013; 2013:720858. DOI:10.1155/2013/720858 · 1.73 Impact Factor
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