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Morbidity and mortality associated with intraperitoneal chemotherapy for Pseudomyxoma peritonei
Sonia A Butterworth1, O Neely M Panton, David J Klaassen
1Department of Surgery, British Columbia Cancer Agency, University of British Columbia, 855 West 10th Ave., Vancouver, BC, Canada V5Z 1L7.
Background:
Many centers include intraperitoneal chemotherapy for treatment of pseudomyxoma peritonei. This study documented the morbidity of intraperitoneal chemotherapy in a single institution.
Methods:
A retrospective review of pseudomyxoma peritonei over a 6-year period was undertaken. Treatment, morbidity, and outcome were documented.
Results:
Eleven patients were identified with an average of 1.9 debulking procedures and 0.8 chemotherapy courses (0.3 complete). Intraperitoneal chemotherapy was not completed in 5 patients because of complications (56%): severe abdominal pain, seizure, neutropenia, and thrombocytopenia (the latter resulted in 1 patient's death). There was no association between incomplete chemotherapy and recurrence. Recurrence was 64% in those without chemotherapy and 44% in those with. Follow-up averaged 26 months and actual 3-year survival was 60%.
Conclusions:
Intraperitoneal chemotherapeutic morbidity and mortality were 56% and 11%, respectively. Chemotherapy was associated with decreased recurrence. To optimize outcomes, multicenter prospective trials will likely be required to further refine intraperitoneal chemotherapy protocols.