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Pseudomyxoma peritonei
Abstract:
Thirty-eight patients with pseudomyxoma peritonei were treated at the M. D. Anderson Hospital, Houston, from 1954 to 1978. The various treatment regimens used have provided actuarial survival rates of 54% at five years and 18% at ten years. Local or regional disease was the cause of death in 68% of patients, and no patient died of metastatic disease. Initial definitive surgery should consist of effective tumor reduction, omentectomy, appendectomy, and, in the female subject, bilateral oophorectomy. Most patients have been treated adjunctively with either fluorouracil or melphalan (L-phenylalanine mustard) depending on the presumed site of origin, but results in a small number of patients treated with either whole abdominal or strip abdominal radiotherapy suggest that this modality may offer improved survival. Treatment with adjunctive radiotherapy alone has provided a five-year survival rate of 75%, compared with 44% for chemotherapy.
Insights
Pseudomyxoma peritonei treatment combining surgery with radiotherapy offers improved survival rates compared to chemotherapy. Effective tumor reduction and omentectomy are crucial initial surgical steps for this rare cancer.
Area of Science:
- Oncology
- Surgical Oncology
Background:
- Pseudomyxoma peritonei is a rare malignancy.
- Treatment outcomes for pseudomyxoma peritonei have historically varied.
Purpose of the Study:
- To evaluate the survival rates and efficacy of different treatment regimens for pseudomyxoma peritonei.
- To identify optimal surgical and adjunct treatment strategies.
Main Methods:
- Retrospective analysis of 38 patients treated between 1954 and 1978.
- Comparison of survival rates based on surgical interventions, chemotherapy (fluorouracil, melphalan), and radiotherapy.
Main Results:
- Actuarial survival rates were 54% at five years and 18% at ten years.
- Adjunctive radiotherapy alone showed a 75% five-year survival rate, compared to 44% for chemotherapy.
- Local or regional disease caused death in 68% of patients; no metastatic death occurred.
Conclusions:
- Initial surgery should involve tumor reduction, omentectomy, appendectomy, and oophorectomy in females.
- Radiotherapy may offer improved survival for pseudomyxoma peritonei compared to chemotherapy.
- Further research into multimodal treatment approaches is warranted.