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Systematic review of the Sugarbaker procedure for pseudomyxoma peritonei
J Bryant1, A J Clegg, M K Sidhu
1Southampton Health Technology Assessments Centre, Wessex Institute for Health Research and Development, University of Southampton, Southampton, UK. J.S.Bryant@soton.ac.uk
Background:
Pseudomyxoma peritonei, a rare progressive disease process within the peritoneum, is characterized by an abundance of mucinous fluid; if left untreated, the condition is fatal. The aim of this article is to assess the clinical effectiveness and costs of the Sugarbaker procedure for pseudomyxoma peritonei.
Methods:
A systematic review of the literature up to April 2004 was undertaken, with modelling of costs.
Results:
Five retrospective case-series reports met the inclusion criteria. Survival after operation was approximately 95 per cent at 2 years and 60-68 per cent at 10 years, with 41-52 per cent of patients having no evidence of disease at the end of follow-up. A Monte Carlo simulation model estimated the marginal cost for one patient over a maximum of 5 years to be about pound 9700 (standard deviation pound 1300).
Conclusion:
Evidence of the effectiveness of the Sugarbaker procedure for pseudomyxoma peritonei is limited in quantity and quality, but suggests there may be some benefit for patients. The marginal cost of the operation is about pound 9700, provided that trained and experienced staff are available to perform the procedure.
Insights
The Sugarbaker procedure shows potential benefit for pseudomyxoma peritonei, a rare fatal condition. While evidence is limited, survival rates are promising, with an estimated marginal cost of approximately £9700.
Area of Science:
- Oncology
- Surgical Oncology
- Gastroenterology
Background:
- Pseudomyxoma peritonei is a rare, progressive, and fatal peritoneal disease.
- Characterized by excessive mucinous fluid accumulation in the peritoneum.
- Urgent need for effective treatment strategies.
Purpose of the Study:
- To evaluate the clinical effectiveness of the Sugarbaker procedure for pseudomyxoma peritonei.
- To assess the associated costs of the Sugarbaker procedure.
- To analyze survival outcomes and disease status post-procedure.
Main Methods:
- Systematic literature review up to April 2004.
- Inclusion of five retrospective case-series reports.
- Cost-effectiveness analysis using a Monte Carlo simulation model.
Main Results:
- Approximate survival rates: 95% at 2 years, 60-68% at 10 years.
- 41-52% of patients showed no evidence of disease at follow-up.
- Estimated marginal cost: ~£9700 per patient over 5 years (SD £1300).
Conclusions:
- Limited but suggestive evidence of benefit from the Sugarbaker procedure for pseudomyxoma peritonei.
- Procedure cost is approximately £9700, contingent on experienced staff availability.
- Further high-quality research is warranted to confirm efficacy.