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[Treatment of pseudomyxoma peritonei using cytoreduction and intraperitoneal hyperthermic chemotherapy]
S Scuderi1, D Costamagna, M Vaira
1Centro di Chirurgia Oncologica Avanzata, Università, Torino.
Abstract:
Pseudomixoma peritonei (PMP) is a rare neoplasia with a low grade of clinical malignity. Generally, the main treatment of this tumor is the surgical debulking. Best results are obtained combining surgery and hyperthermic antiblastic peritoneal perfusion (HAPP) with CDDP and MMC. From April '97 to March 2003, we operated on 132 patients, 8 times with a palliative intent. In 27 times we achieved a complete cytoreduction (17 CC0 and 10 CC1) followed by HAPP. As regards results, no post-operative mortality was reported and 19% of major morbidity was observed. 26 patients are NED at maximum follow-up of 6 years and 1 patient had recurrence 6 months after primary resection. We believe that cytoreduction and HAPP is the golden standard of PMP therapy when it is possible to achieve a complete cytoreduction. Most of the times, the disease is not radically treated and therefore, after diagnosis, patients should be only referred to specialized centers.
Insights
Pseudomixoma peritonei (PMP) treatment combining cytoreductive surgery and hyperthermic antiblastic peritoneal perfusion (HAPP) offers excellent results for patients with PMP. This approach is considered the gold standard for PMP therapy when complete cytoreduction is achievable.
Area of Science:
- Oncology
- Surgical Oncology
Context:
- Pseudomixoma peritonei (PMP) is a rare, low-grade malignancy.
- Surgical debulking is the primary treatment modality for PMP.
Purpose:
- To evaluate the efficacy of cytoreductive surgery combined with hyperthermic antiblastic peritoneal perfusion (HAPP) using CDDP and MMC in PMP patients.
- To establish the gold standard for PMP treatment.
Summary:
- 132 PMP patients underwent surgery between April 1997 and March 2003, with 27 achieving complete cytoreduction followed by HAPP.
- No post-operative mortality was observed, with 19% major morbidity. 26 patients remained disease-free at 6-year follow-up.
Impact:
- Cytoreductive surgery and HAPP represent the gold standard for PMP therapy when complete cytoreduction is feasible.
- Patients diagnosed with PMP should be referred to specialized centers for optimal management.