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Recurrence after cytoreductive surgery and HIPEC for pseudomyxoma peritonei: A single-center retrospective cohort
Antti Yrjönen1, Laura Koskenvuo2, Carola Haapamäki2
1Jorvi Hospital, Ambulatory Surgery Unit, Karvasmäentie 8, Espoo 02740 Finland.
Background And Aims:
Pseudomyxoma peritonei (PMP) is a rare disease characterized by progressive build-up of mucinous deposits inside the abdominal cavity. The aim of this study was to investigate the effect of disease recurrence on overall survival in patients with PMP after cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC).
Methods:
One-hundred thirty-two consecutive PMP patients treated with CRS + HIPEC at Helsinki University Hospital between 2008 and 2017 were included. The impact of clinicopathological and treatment-related characteristics on recurrence and overall survival was evaluated.
Results:
The median follow-up time in the study was 5.04 (range = 0.05-11.60) years. In 121 (91.7%) patients, the disease was classified as low grade and 11 (8.3%) had high-grade disease. In the low-grade group, 26 (21.5%) patients developed a recurrence during follow-up compared to 6 (54.5%) patients in the high-grade group. In the low-grade group, cumulative survival was 98.2%, 91.4%, and 91.4% at 3, 6, and 8 years, respectively. In the high-grade group, cumulative survival was 90.0% and 78.8% at 3 and 6 years, respectively. In patients with recurrent disease, the cumulative survival was 100%, 84.6%, and 84.6% at 3, 6, and 8 years in the low-grade category and 80.0% and 60.0% at 3 and 6 years in the high-grade category, respectively. In the low-grade group, a statistically significant correlation with recurrence but not with overall survival was identified with peritoneal cancer index (PCI), carcinoembryonic antigen (CEA), and the number of affected regions.
Conclusion:
The recurrence of low-grade PMP does not significantly affect overall survival of patients. Disease extent may not be a prognostic indicator after curative CRS and HIPEC in low-grade PMP.
Insights
Recurrence of low-grade pseudomyxoma peritonei (PMP) after cytoreductive surgery and HIPEC does not significantly impact overall survival. Disease extent is not a reliable prognostic indicator in these patients.
Area of Science:
- Oncology
- Surgical Oncology
- Gastroenterology
Background:
- Pseudomyxoma peritonei (PMP) is a rare condition involving mucinous deposits in the abdomen.
- Understanding factors affecting survival post-treatment is crucial for patient management.
Purpose of the Study:
- To evaluate the impact of disease recurrence on overall survival in PMP patients.
- To assess prognostic indicators following cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).
Main Methods:
- Retrospective analysis of 132 PMP patients treated with CRS + HIPEC.
- Evaluation of clinicopathological factors and treatment characteristics related to recurrence and survival.
Main Results:
- Low-grade PMP recurred in 21.5% of patients, while high-grade PMP recurred in 54.5%.
- Recurrence of low-grade PMP did not significantly affect overall survival.
- Peritoneal Cancer Index (PCI), CEA, and affected regions showed correlation with recurrence but not overall survival in low-grade PMP.
Conclusions:
- Recurrence of low-grade PMP does not significantly alter overall survival.
- Disease extent may not be a prognostic factor after curative CRS and HIPEC for low-grade PMP.
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