Cytoreductive surgery and hyperthermic intra-peritoneal chemotherapy (HIPEC) in the treatment of pseudomyxoma peritonei: ten years experience in a single center.

Abstract

BACKGROUND: Pseudomyxoma peritonei (PMP) is a rare and fatal disease for which no standard treatment has been established. Encouraging results have been recently reported with the combination of cytoreductive surgery (CRS) and hyperthermic intra-peritoneal chemotherapy (HIPEC). PATIENTS AND METHODS: Seventy-five patients with PMP underwent CRS and closed abdomen HIPEC with mytomicin-C and cis-platinum over 10 years at a single institution. Potential clinicopathological prognostic variables were tested using multivariate analysis. RESULTS: Optimal cytoreduction (residual tumor nodules < or = 2.5 mm) was performed in 72 patients (96%). Operative mortality was 1%. Five-year overall (OS) and progression-free (PFS) survival were 78.3% and 31.1% in the overall series, respectively. Optimal CRS, no previous systemic chemotherapy and low histological aggressiveness were independent predictors of better OS and PFS using multivariate analysis. CONCLUSION: Favourable outcome after CRS and HIPEC can be expected in patients affected by PMP variants with low histological aggressiveness, undergoing optimal surgical cytoreduction and with no pre-operative systemic chemotherapy.