General and Upper GI Surgery Division, University of Verona, Piazzale Stefani, 1, 37124, Verona, Italy.
Updates Surg. 2020 Dec;72(4):1207-1212. doi: 10.1007/s13304-020-00788-5. Epub 2020 May 14.
Pseudomyxoma peritonei (PMP) is a rare condition characterized by the intraperitoneal accumulation of mucus derived mostly by appendiceal mucinous neoplasm. Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) can offer a favourable overall survival. In this study, we report a single-institute outcomes following CRS and HIPEC in patients with this condition. This is a review of prospectively collected data from 32 patients (11 men and 21 women) affected by PMP of appendiceal origin who underwent CRS and HIPEC from 2008 to 2016 in our Surgical Unit of General and Esophagogastric Surgery. The median age of the patients was 53 years (range 25-77 years). After CRS, all patients underwent HIPEC (mytomicin C 3.3 mg/m/L and cisplatin 25 mg/m/L at 41 °C for 60 min) with closed abdomen technique. The median (range) follow-up time for surviving patients was 43 (18-119) months. The median peritoneal cancer index (PCI) was 17. Complete cytoreductive surgery (CC0) was achieved in in 22 patients (69%). The majority of patients (88%) had grade I-II complications, 3 (9%) had grade III complications, and 1 (3%) patient had a grade IV complication. There were no perioperative mortalities. The median hospital stay was 9.5 (range 9-24) days. One year and 5-year overall survival (OS) were 90% and 58%, respectively. Regardless of histotype, disease-free survival was 95% at 1 year and 46% at 5 years. CRS in combination with HIPEC is a feasible treatment strategy and can achieve a satisfactory outcome in patients with PMP of appendiceal origin.
腹膜假性黏液瘤（PMP）是一种罕见的疾病，其特征为腹腔内积聚的黏液主要来自阑尾黏液性肿瘤。细胞减灭术（CRS）联合腹腔热灌注化疗（HIPEC）可提供较好的总生存。本研究报告了我们外科普通和食管胃手术组 2008 年至 2016 年间收治的 32 例阑尾来源 PMP 患者行 CRS 和 HIPEC 的单中心结果。这是对前瞻性收集的 32 例（男 11 例，女 21 例）阑尾来源 PMP 患者的资料进行的回顾性分析，所有患者均行 CRS 和 HIPEC（美司钠 3.3mg/m/L 和顺铂 25mg/m/L，在 41°C 下持续 60 分钟），采用闭腹技术。生存患者的中位随访时间为 43（18-119）个月。中位腹膜肿瘤指数（PCI）为 17。22 例（69%）患者达到完全肿瘤细胞减灭术（CC0）。大多数患者（88%）有 I-II 级并发症，3 例（9%）有 III 级并发症，1 例（3%）有 IV 级并发症。无围手术期死亡。中位住院时间为 9.5 天（范围 9-24 天）。1 年和 5 年总生存率（OS）分别为 90%和 58%。无论组织学类型如何，1 年无病生存率为 95%，5 年无病生存率为 46%。CRS 联合 HIPEC 是一种可行的治疗策略，可使阑尾来源 PMP 患者获得满意的疗效。
