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Prognostic value of the ascites characteristics in pseudomyxoma peritonei originating from the appendix
Bing Wang1,2, Xibo Sun3, Ruiqing Ma4
1Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
Background:
Pseudomyxoma peritonei (PMP) is a rare disease, with the overall survival (OS) influenced by many factors. To date, no ascites characteristics have been reported to predict OS of patients with PMP. The present study therefore aims to describe the ascites characteristics for PMP and identify prognostic factors for survival.
Methods:
Between June 2010 and June 2020, 473 PMP patients who underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy were included in a retrospective study. Survival analysis was performed with the Kaplan-Meier method by the log-rank test and a Cox proportional hazards model. Associations between categorical variables were analyzed using the chi-squared test.
Results:
Among all included patients, 61% were women. The median OS was 47 months (range, 4-124 months) at the last follow-up in December 2020. Ascites characteristics can be divided into light blood ascites, "Jelly" mucus ascites, and faint yellow and clear ascites. Multivariate Cox analysis showed that the degree of radical surgery, ascites characteristics, and pathological grade were independently associated with OS in PMP patients. The chi-squared test documented that faint yellow "Jelly" ascites were related to low-grade PMP and light blood ascites were associated with high-grade PMP (P < 0.01).
Conclusions:
Light blood ascites, incomplete cytoreduction surgery, and high-grade histopathology may predict poor OS in appendix-derived PMP.
Insights
Pseudomyxoma peritonei (PMP) ascites characteristics can predict overall survival (OS). Light blood ascites, incomplete surgery, and high-grade pathology indicate poor OS in PMP patients.
Area of Science:
- Oncology
- Gastroenterology
- Surgical Oncology
Background:
- Pseudomyxoma peritonei (PMP) is a rare malignancy with variable overall survival (OS).
- Predictive factors for PMP patient survival remain incompletely understood.
- Ascites characteristics have not been previously established as prognostic indicators for PMP.
Purpose of the Study:
- To characterize ascites in patients with Pseudomyxoma peritonei (PMP).
- To identify prognostic factors influencing overall survival (OS) in PMP patients.
- To explore the association between ascites characteristics and PMP grade.
Main Methods:
- Retrospective analysis of 473 PMP patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (2010-2020).
- Survival analysis using Kaplan-Meier method, log-rank test, and Cox proportional hazards model.
- Chi-squared test to assess associations between categorical variables, including ascites characteristics and PMP grade.
Main Results:
- Median OS was 47 months. Ascites types included light blood, "Jelly" mucus, and faint yellow/clear.
- Multivariate Cox analysis identified radical surgery extent, ascites characteristics, and pathological grade as independent predictors of OS.
- Faint yellow "Jelly" ascites correlated with low-grade PMP, while light blood ascites associated with high-grade PMP (P < 0.01).
Conclusions:
- Light blood ascites, incomplete cytoreduction, and high-grade histopathology are associated with poor overall survival in appendix-derived PMP.
- Ascites characteristics represent a novel prognostic factor for PMP.
- These findings aid in risk stratification and personalized treatment strategies for PMP.
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