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Loungnarath Rasmy M.D.; Causeret, Sylvain M.D.; Bossard, Nadine M.D., Ph.D.; Faheez, Mohamed M.B.Ch.B., M.R.C.S.; Sayag-Beaujard, Annie-Claude M.D.; Brigand, Cécile M.D.; Gilly, François M.D., Ph.D.; Glehen, Olivier M.D., Ph.D.
Diseases of the Colon & Rectum: July 2005
doi: 10.1007/s10350-005-0045-5
Original Contribution: PDF Only

PURPOSE: PURPOSE:Pseudomyxoma peritonei is a rare disease. Recently, cytoreductive surgery with intraperitoneal hyperthermic chemotherapy has emerged as a promising treatment for this debilitating condition. The aim of this prospective study was to evaluate this treatment strategy.

METHOD: METHOD:Twenty-seven patients with pseudomyxoma peritonei who were treated by cytoreductive surgery and intraperitoneal chemohyperthermia between 1997 and 2003 were identified from a prospective database.

RESULTS: RESULTS:Clinical presentation included suspected appendicitis (33 percent), increased abdominal girth (30 percent), and a suspected ovarian mass (26 percent). Twenty-two patients underwent surgery elsewhere before referral. Seventeen complications occurred in 12 patients (44 percent). Six were considered major: three anastomotic leaks, two pleural effusions, and one intra-abdominal abscess. Histologic examination demonstrated Grade 1, 2, and 3 disease in 8 (30 percent), 10 (37 percent), and 9 patients (33 percent), respectively. Pathologic grade showed a significant influence on the complication rate (P= 0 0.008). The actuarial five-year survival was 100 percent for patients with Grade 1 disease, whereas actuarial one-, two-, three-, and five-year survival for Grades 2 and 3 were 100, 80, 64, and 32 percent, respectively (P= 0.008).

CONCLUSIONS: CONCLUSIONS:Cytoreductive surgery with intraperitoneal hyperthermic chemotherapy is a feasable treatment for pseudomyxoma peritonei. It is associated with acceptable morbidity when performed by an experienced surgical team. Histologic grade is the major determinant of survival.

aDépartement de Chirurgie Générale, Thoracique et Endocrinienne, Centre Hospitalier Lyon-Sud, 69495, Pierre-Bénite Cédex, France, e-mail: olivier.glehen@chu-lyon.fr

© The ASCRS 2005