Related Experiment Video
Updated: Jan 19, 2026
Culture and Imaging of Ex Vivo Organotypic Pseudomyxoma Peritonei Tumor Slices from Resected Human Tumor Specimens
Published on: December 9, 2022
Intraperitoneal mitomycin C improves survival compared to cytoreductive surgery alone in an experimental model of
Olaf Sørensen1, Anders Mikal Andersen2, Stein Gunnar Larsen1
1Department of Gastroenterological Surgery, Norwegian Radium Hospital, Oslo University Hospital, Montebello, 0310, Oslo, Norway.
Abstract:
Pseudomyxoma peritonei (PMP) is a rare cancer commonly originating from appendiceal neoplasms that presents with mucinous tumor spread in the peritoneal cavity. Patients with PMP are treated with curative intent by cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). The value of adding HIPEC to CRS has not been proven in randomized trials, and the objective of this study was to investigate the efficacy of intraperitoneal mitomycin C (MMC) and regional hyperthermia as components of this complex treatment. Xenograft tissue established from a patient with histologically high-grade PMP with signet ring cell differentiation was implanted intraperitoneally in 65 athymic nude male rats and the animals were stratified into three treatment groups; the cytoreductive surgery group (CRSG, CRS only), the normothermic group (NG, CRS and intraperitoneal chemotherapy perfusion (IPEC) with MMC at 35 ºC), and the hyperthermic group (HG, CRS and IPEC at 41 ºC). The main endpoints were survival and tumor weight at autopsy. Adequate imitation of the clinical setting and treatment approach was achieved. The median survival was 31 days in the CRSG, 60 days in NG and 67 days in HG. The median tumor weights at autopsy were 34 g in CRSG, 23 g NG and 20 g in HG. In conclusion, the addition of IPEC with MMC after CRS doubled the survival time and reduced tumor growth compared to CRS alone. Adding regional hyperthermia resulted in a modest improvement of treatment outcome.
Insights
Cytoreductive surgery (CRS) combined with intraperitoneal chemotherapy perfusion (IPEC) using mitomycin C (MMC) significantly improved survival for pseudomyxoma peritonei (PMP) in rats. Adding regional hyperthermia offered a modest additional benefit.
Area of Science:
- Oncology
- Surgical Oncology
- Cancer Research
Background:
- Pseudomyxoma peritonei (PMP) is a rare malignancy originating from appendiceal neoplasms, characterized by mucinous tumor spread within the peritoneal cavity.
- Current treatment for PMP involves cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC), though its efficacy is not definitively established by randomized trials.
Purpose of the Study:
- To evaluate the efficacy of intraperitoneal mitomycin C (MMC) and regional hyperthermia as adjuncts to CRS in a preclinical model of PMP.
- To investigate the impact of normothermic versus hyperthermic intraperitoneal chemotherapy perfusion on treatment outcomes.
Main Methods:
- A xenograft model of high-grade PMP with signet ring cell differentiation was established in athymic nude rats.
- Animals were divided into three groups: CRS alone (CRSG), CRS with normothermic intraperitoneal chemotherapy perfusion (NG), and CRS with hyperthermic intraperitoneal chemotherapy perfusion (HG).
- Primary endpoints included survival duration and tumor weight at autopsy.
Main Results:
- Median survival was 31 days for CRSG, 60 days for NG, and 67 days for HG.
- Median tumor weights at autopsy were 34 g for CRSG, 23 g for NG, and 20 g for HG.
- IPEC with MMC after CRS doubled survival and reduced tumor burden compared to CRS alone.
Conclusions:
- The addition of intraperitoneal chemotherapy perfusion with MMC to CRS significantly enhances survival and reduces tumor growth in PMP.
- Regional hyperthermia provides a modest additional benefit to the combined CRS and IPEC treatment for PMP.
