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Primary peritonectomy/HIPEC for disseminated peritoneal adenomucinosis achieves much lower recurrence rates and
1The University of New South Wales, Department of Surgery, St. George Hospital, Sydney, New South Wales, Australia.
Background:
Two main treatment options are available for pseudomyxoma peritonei (PMP) and disseminated peritoneal adenomucinosis (DPAM)--incomplete cytoreductive (debulking) surgery and peritonectomy with intraperitoneal chemotherapy. Several studies have demonstrated improved survival with peritonectomy. This study analyses outcome following peritonectomy in patients undergoing a primary procedure compared to those who have had previous debulks.
Methods:
Between April 1997 and May 2008, 63 patients underwent peritonectomy for DPAM--38 had had previous debulk(s) and 25 underwent primary peritonectomy. Patients were followed-up at three- to six-monthly intervals postoperatively, with a mean follow-up time of 21 and 34 months, respectively.
Results:
Mean survival for patients undergoing primary peritonectomy was 109.8 months. Mean survival for patients with previous debulks was 49.2 months (p=0.027). Five-year survival was 95.5% in the primary peritonectomy group and 67.5% in the previous debulk group.
Conclusion:
Disease recurrence after primary peritonectomy for DPAM is significantly less frequent than after secondary peritonectomy.
