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Therapy of pseudomyxoma peritonei of appendiceal origin--surgical resection and intraperitoneal chemotherapy

W P Hosch1, J Rudi, W Stremmel

  • 1Department of Gastroenterology, University of Heidelberg.

Zeitschrift Fur Gastroenterologie
|August 24, 1999
PubMed

Insights

Pseudomyxoma peritonei (PMP) is a rare condition causing mucus on the peritoneum, often from the appendix. Intraperitoneal chemotherapy with 5-FU, mitomycin C, or cisplatin is recommended for appendiceal PMP due to high recurrence rates.

Area of Science:

  • Oncology
  • Gastroenterology
  • Surgical Pathology

Background:

  • Pseudomyxoma peritonei (PMP) is a rare condition characterized by mucinous lesions on the peritoneal surface.
  • Typically affects middle-aged or older adults, with an incidence of approximately 2 in 10,000 laparotomies.
  • Most cases originate from the appendix or ovaries, presenting insidiously with long-term survival and minimal distant spread.

Purpose of the Study:

  • To review the literature on Pseudomyxoma peritonei (PMP) and its treatment.
  • To present ten cases of PMP of appendiceal origin.
  • To recommend effective treatment strategies for PMP, particularly intraperitoneal chemotherapy.

Main Methods:

  • Literature review on Pseudomyxoma peritonei (PMP) and its management.
  • Analysis of ten cases of PMP with appendiceal origin.
  • Evaluation of treatment efficacy, focusing on surgical resection and chemotherapy.

Main Results:

  • Surgical resection and removal of mucinous material are the primary treatments for PMP.
  • Disease recurrence is common, and adjuvant/palliative chemotherapy regimens are not well-established.
  • Intraperitoneal chemotherapy may offer superior local drug concentrations compared to systemic administration.

Conclusions:

  • Intraperitoneal chemotherapy with 5-FU, mitomycin C, or cisplatin is recommended for appendiceal PMP.
  • This approach is based on the potential for higher local drug concentrations and the experience from ten reported cases.
  • Further research into standardized chemotherapy regimens for PMP is warranted.

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