Pseudomyxoma peritonei and the urinary tract: involvement and treatment related complications
R M Smeenk1, A Bex, V J Verwaal
1Department of Surgery, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
Background:
Pseudomyxoma peritonei (PMP) is a rare clinical syndrome characterized by intraperitoneal accumulation of mucus produced by neoplastic cells of mostly appendiceal origin. The aim of this study was to analyze primary and secondary involvement and treatment-related complications of the urinary tract in PMP.
Methods:
A retrospective study of 92 patients with PMP, treated by cytoreduction and intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) at The Netherlands Cancer Institute between 1996 and 2004.
Results:
Seven patients presented with involvement of the urinary tract. Major urologic complications occurred in five patients, of which two had secondary involvement of the urinary tract. Major urologic complications consisted predominantly of surgical complications related to the bladder. All patients with secondary involvement and/or urologic complications had undergone previous pelvic surgery.
Conclusions:
The urinary tract is rarely involved in patients with PMP. Secondary involvement is mostly observed and may be a result of seeding of PMP of pelvic origin after prior pelvic surgery. There is a low urologic complication risk of treatment with cytoreduction and HIPEC. The combination of secondary involvement and previous pelvic surgery is an omen of treatment-related urologic complications, necessitating (surgical) re-interventions and further management in close collaboration with urologists.
Insights
Urinary tract involvement is rare in pseudomyxoma peritonei (PMP). Secondary PMP involvement, often after pelvic surgery, can lead to complications, but cytoreduction and HIPEC have a low urologic complication risk.
Area of Science:
- Oncology
- Urology
- Surgical Oncology
Background:
- Pseudomyxoma peritonei (PMP) is a rare condition involving mucus accumulation in the abdomen from neoplastic cells, typically appendiceal.
- Urinary tract involvement in PMP is uncommon, with both primary and secondary presentations possible.
Purpose of the Study:
- To investigate the incidence of primary and secondary urinary tract involvement in PMP patients.
- To analyze treatment-related complications affecting the urinary tract in PMP.
Main Methods:
- Retrospective analysis of 92 PMP patients treated with cytoreduction and intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC).
- Data collected from The Netherlands Cancer Institute between 1996 and 2004.
Main Results:
- Seven patients (7.6%) showed urinary tract involvement.
- Major urologic complications occurred in five patients, primarily bladder-related surgical issues.
- All patients with secondary involvement or urologic complications had prior pelvic surgery.
Conclusions:
- The urinary tract is infrequently affected in PMP.
- Secondary involvement, often post-pelvic surgery, is the predominant pattern.
- Cytoreduction and HIPEC demonstrate a low risk of urologic complications, though prior surgery increases risk.
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