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Pseudomyxoma peritonei treated by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: results from a single centre.
- Source :
-
Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico [Clin Transl Oncol] 2011 Apr; Vol. 13 (4), pp. 261-7. - Publication Year :
- 2011
-
Abstract
- Background: Pseudomyxoma peritonei (PMP) is a rare, slowly progressive disease whose prognosis depends primarily on the completeness of cytoreduction. The value of intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) and of additional factors predicting long-term outcome and disease-free survival (DFS) remains poorly understood. This study aims to analyse survival rates and prognostic factors in patients undergoing maximal cytoreduction and HIPEC.<br />Methods: Thirty patients were selected from a prospective database of records for patients undergoing cytoreduction and HIPEC with mitomycin C or paclitaxel. Overall survival (OS), DFS, and the prognostic factors influencing them, were examined using multivariate analysis.<br />Results: Median follow-up was 44 months (range, 8-144). Histological classification of PMPs was DPAM in 6/30 of cases, PMCA-I in 10/30 and PMCA in 14/30. Complete cytoreduction (CC-0 and CC-1) was achieved in 28/30 of patients and CC-2 in 2/30. Median OS was 111 months (range 0-230) and five-year OS rate was 67%. Median DFS was 53.5 months (range 0-120) and 5-year DFS rate was 44%. Incomplete cytoreduction, lymph node involvement and PCI>20 were associated with poor prognosis for OS, while lymph node involvement, elevated CA-125 levels, unfavourable histology and previous chemotherapy were associated with poor outcomes for DFS. There was morbidity of Grade 3 or higher in 9/30. Post-operative mortality occurred in 1 case.<br />Conclusion: Cytoreduction plus peritonectomy procedures combined with HIPEC is a safe treatment and could improve survival rates. Since the optimal cytoreduction is the primary prognostic factor, patients should be centralised under the care of experienced teams.
- Subjects :
- Chemotherapy, Cancer, Regional Perfusion
Humans
Mitomycin administration & dosage
Paclitaxel administration & dosage
Antineoplastic Agents administration & dosage
Hyperthermia, Induced
Peritoneal Neoplasms drug therapy
Peritoneal Neoplasms surgery
Pseudomyxoma Peritonei drug therapy
Pseudomyxoma Peritonei surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1699-3055
- Volume :
- 13
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico
- Publication Type :
- Academic Journal
- Accession number :
- 21493187
- Full Text :
- https://doi.org/10.1007/s12094-011-0651-8