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Risk Factors for Pseudomyxoma Peritonei in Appendiceal Mucinous Neoplasms: A Single-Center Experience
Jorge Luis Leal-Hidalgo1, Kevin Joseph Fuentes-Calvo2, Sara Fernanda Arechavala-Lopez3
1General Surgery, Facultad Mexicana de Medicina, Universidad La Salle México, Mexico City, MEX.
Introduction:
Appendiceal mucinous neoplasms (AMNs) are rare tumors with the potential to progress to pseudomyxoma peritonei (PMP). Identification of prognostic factors may improve surgical management and follow-up strategies.
Objective:
This study aimed to analyze clinicopathological factors associated with the development of PMP in patients with AMNs treated at a tertiary care hospital in Mexico.
Methods:
A retrospective study was conducted in Hospital Médica Sur, Mexico City, Mexico, including 30 patients with histologically confirmed AMNs between 2018 and 2023. Clinical, surgical, histological, and laboratory variables were analyzed. Bivariate analyses and binary logistic regression models were performed to identify factors associated with the development of PMP.
Results:
Appendiceal perforation was the only factor significantly associated with the development of PMP, as the absence of perforation was linked to significantly lower odds of disease (odds ratio (OR): 0.090; 95% confidence interval (CI): 0.010-0.798; p = 0.031). Histological subtypes other than low-grade appendiceal mucinous neoplasm (LAMN) showed a nonsignificant trend toward association (p = 0.076).
Conclusion:
Appendiceal perforation was the main factor associated with the development of PMP in this cohort. Its identification may help guide surgical decision-making and individualized postoperative surveillance strategies.
Insights
Appendiceal perforation is linked to pseudomyxoma peritonei (PMP) development in appendiceal mucinous neoplasms (AMNs). Avoiding perforation significantly reduces PMP risk, guiding surgical and surveillance strategies for these rare tumors.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Pathology
Background:
- Appendiceal mucinous neoplasms (AMNs) are rare tumors with malignant potential.
- Progression to pseudomyxoma peritonei (PMP) is a significant concern.
- Identifying prognostic factors is crucial for optimizing patient management.
Purpose of the Study:
- To investigate clinicopathological factors associated with PMP development in AMN patients.
- To analyze data from a tertiary care hospital in Mexico.
- To inform surgical and follow-up strategies.
Main Methods:
- Retrospective study of 30 patients with confirmed AMNs (2018-2023).
- Analysis of clinical, surgical, histological, and laboratory variables.
- Bivariate analyses and logistic regression to identify risk factors for PMP.
Main Results:
- Appendiceal perforation was the sole significant factor associated with PMP development (OR: 0.090, p=0.031).
- Absence of perforation correlated with substantially lower odds of PMP.
- Non-LAMN histological subtypes showed a trend towards association (p=0.076).
Conclusions:
- Appendiceal perforation is the primary predictor of PMP in this AMN cohort.
- Early identification of perforation can guide surgical decisions.
- Findings support individualized postoperative surveillance for PMP risk stratification.
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