Survival of patients with pseudomyxoma peritonei treated by serial debulking


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Abstract

AimWe evaluated the outcome of patients with pseudomyxoma peritonei (PMP) after traditional debulking. PMP is a clinical condition characterized by disseminated intraperitoneal mucinous tumours often accompanied by mucinous ascites derived usually from an appendiceal neoplasm. Patients with PMP have traditionally been treated by serial debulking, but aggressive cytoreduction followed by hyperthermic intraperitoneal chemotherapy is now advocated as standard treatment in PMP.MethodThe analysis included 33 consecutive patients with PMP who underwent traditional debulking surgery between June 1984 and August 2008. The patient characteristics and details of the treatment were analysed retrospectively. The primary end-point was survival.ResultsThe overall 5- and 10-year survival rates were 67% and 31% respectively. The patients underwent an average of 3.2 ± 0.4 operations (range 1–10). Of 33 patients, 23 (70%) underwent only 1–3 operations. The 30-day operative mortality rate was 2.7%. However, four patients (12%) seemed to have achieved long-term disease-free survival of more than 5 years.ConclusionsThe 5-year survival is comparable with results achieved in patients receiving a combination of cytoreductive surgery and intraperitoneal chemotherapy, but in the long term, the latter seems superior.

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