Center for Gastrointestinal Malignancies, MedStar Washington Hospital Center, Washington, District Columbia, USA.
Westat, Rockville, Maryland, USA.
J Surg Oncol. 2021 Sep;124(3):378-389. doi: 10.1002/jso.26506. Epub 2021 Apr 29.
Pseudomyxoma peritonei is a disease caused by the widespread distribution of mucinous tumor into the peritoneal space from a perforated appendiceal neoplasm.
All patients in this study had cytoreductive surgery with total gastrectomy plus perioperative intraperitoneal chemotherapy. A high diverting jejunostomy was used on all patients. Patient characteristics, adverse events, and survival were accumulated prospectively.
Fifty-eight patients were available for long-term follow-up. In the univariate analysis, features associated with a less favorable outcome included female gender (p = 0.0127), intestinal obstruction before treatment (p = 0.00791), and prior surgical score (PSS) (p = 0.0054). In the multivariate analysis, the two significant variables were grade (p = 0.0458) and PSS (p = 0.0041). Median survival was 12 years with a 5-, 10-, and 20-year survival of 76%, 58%, and 37%, respectively. There were two postoperative deaths (3.4%) and Grades 3 and 4 adverse events in 20 (34.5%) patients.
A 10-year survival after cytoreductive surgery, total gastrectomy with temporary high diverting jejunostomy, and perioperative chemotherapy occurred in 58% of these patients with advanced pseudomyxoma peritonei. High-grade disease and extensive prior surgery with a high PSS were associated with reduced benefit.
假性黏液瘤是一种疾病，由穿孔的阑尾肿瘤将黏液性肿瘤广泛分布到腹膜腔引起。
本研究中的所有患者均接受了细胞减灭术联合全胃切除术和围手术期腹腔内化疗。所有患者均使用高转流空肠造口术。前瞻性地积累了患者特征、不良事件和生存情况。
58 例患者可进行长期随访。在单因素分析中，与预后不良相关的特征包括女性（p=0.0127）、治疗前肠梗阻（p=0.00791）和术前手术评分（PSS）（p=0.0054）。在多因素分析中，两个显著变量是分级（p=0.0458）和 PSS（p=0.0041）。中位生存时间为 12 年，5 年、10 年和 20 年生存率分别为 76%、58%和 37%。有 2 例术后死亡（3.4%）和 20 例（34.5%）患者出现 3 级和 4 级不良事件。
在这些晚期假性黏液瘤患者中，有 58%的患者在接受细胞减灭术、全胃切除术伴临时高转流空肠造口术和围手术期化疗后 10 年生存。高级别疾病和广泛的既往手术且 PSS 较高与获益减少相关。
