[Pseudomyxoma peritonei treated with complete resection and immediate intraperitoneal chemotherapy]

Area of Science:

• Oncology
• Surgical Oncology
• Gastroenterology

Background:

• Pseudomyxoma peritonei (PMP) is a rare malignancy with a poor prognosis.
• Complete resection of macroscopic lesions and treatment of microscopic disease are crucial for survival.
• Prognostic factors include pathological grade and completeness of surgical resection.

Purpose of the Study:

• To evaluate the efficacy of combining complete surgical resection with early intraperitoneal chemotherapy for PMP.
• To assess the impact of pathological grading on patient outcomes.
• To compare early postoperative intraperitoneal chemotherapy with intraoperative chemohyperthermia.

Main Methods:

• A prospective study of 36 patients with PMP.
• Surgical resection of macroscopic lesions followed by either early postoperative intraperitoneal chemotherapy or intraoperative chemohyperthermia.
• Comparison with 15 patients who had partial resection without peritoneal chemotherapy.

Main Results:

• Overall 5-year survival rate was 66%, with disease-free survival at 55%.
• Postoperative mortality was 13.8%, and morbidity was 44%.
• Pathological grade was the main prognostic factor: 5-year survival was 74% for grade 1 vs. 54% for grades 2-3 (P=0.05).

Conclusions:

• Complete resection and pathological grading are key prognostic factors in PMP.
• Intraperitoneal chemohyperthermia improves long-term survival, particularly for grades 2-3 tumors.
• Early administration of this treatment strategy is more effective and better tolerated.