Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in pseudomyxoma peritonei of appendiceal origin: result of a single centre study
Related Experiment Video
Updated: Dec 21, 2025
Culture and Imaging of Ex Vivo Organotypic Pseudomyxoma Peritonei Tumor Slices from Resected Human Tumor Specimens
Published on: December 9, 2022
Alberto Di Leo1, Arianna Corvasce2, Jacopo Weindelmayer2
1General and Upper GI Surgery Division, University of Verona, Piazzale Stefani, 1, 37124, Verona, Italy. dileomd@libero.it.
Abstract:
Pseudomyxoma peritonei (PMP) is a rare condition characterized by the intraperitoneal accumulation of mucus derived mostly by appendiceal mucinous neoplasm. Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) can offer a favourable overall survival. In this study, we report a single-institute outcomes following CRS and HIPEC in patients with this condition. This is a review of prospectively collected data from 32 patients (11 men and 21 women) affected by PMP of appendiceal origin who underwent CRS and HIPEC from 2008 to 2016 in our Surgical Unit of General and Esophagogastric Surgery. The median age of the patients was 53 years (range 25-77 years). After CRS, all patients underwent HIPEC (mytomicin C 3.3 mg/m2/L and cisplatin 25 mg/m2/L at 41 °C for 60 min) with closed abdomen technique. The median (range) follow-up time for surviving patients was 43 (18-119) months. The median peritoneal cancer index (PCI) was 17. Complete cytoreductive surgery (CC0) was achieved in in 22 patients (69%). The majority of patients (88%) had grade I-II complications, 3 (9%) had grade III complications, and 1 (3%) patient had a grade IV complication. There were no perioperative mortalities. The median hospital stay was 9.5 (range 9-24) days. One year and 5-year overall survival (OS) were 90% and 58%, respectively. Regardless of histotype, disease-free survival was 95% at 1 year and 46% at 5 years. CRS in combination with HIPEC is a feasible treatment strategy and can achieve a satisfactory outcome in patients with PMP of appendiceal origin.
Insights
Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) offers favorable survival for pseudomyxoma peritonei (PMP). This study shows CRS and HIPEC are feasible and effective for appendiceal PMP, achieving good outcomes.
Area of Science:
- Oncology
- Surgical Oncology
- Gastroenterology
Background:
- Pseudomyxoma peritonei (PMP) is a rare malignancy characterized by intraperitoneal mucus accumulation, often originating from appendiceal mucinous neoplasms.
- Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is a treatment option that can improve overall survival in PMP patients.
Purpose of the Study:
- To report the outcomes of CRS and HIPEC in patients with appendiceal PMP at a single institution.
- To evaluate the feasibility and efficacy of this combined treatment approach.
Main Methods:
- A review of prospectively collected data from 32 patients with appendiceal PMP who underwent CRS and HIPEC between 2008 and 2016.
- HIPEC involved mitomycin C and cisplatin at 41°C for 60 minutes using a closed abdomen technique.
- Data analyzed included patient demographics, peritoneal cancer index (PCI), completeness of cytoreduction (CC0), complications, hospital stay, and survival rates.
Main Results:
- Complete cytoreduction (CC0) was achieved in 69% of patients.
- The majority of complications were grade I-II (88%), with no perioperative mortality.
- One-year and 5-year overall survival rates were 90% and 58%, respectively. One-year and 5-year disease-free survival rates were 95% and 46%.
Conclusions:
- CRS combined with HIPEC is a feasible and effective treatment strategy for pseudomyxoma peritonei of appendiceal origin.
- This approach can achieve satisfactory outcomes, including favorable overall and disease-free survival rates.
- The treatment demonstrates a manageable complication profile and no perioperative mortality.
