Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Pseudomyxoma Peritonei of Appendiceal Origin - 801 Cases from a Single Institution in China

Ao Xia (Department of Myxoma, Aerospace Center Hospital, Beijing, 100049, China)
Xichao Zhai (Department of Myxoma, Aerospace Center Hospital, Beijing, 100049, China)
Lubiao An (Department of Myxoma, Aerospace Center Hospital, Beijing, 100049, China)
Bing Wang (Department of Myxoma, Aerospace Center Hospital, Beijing, 100049, China)
Guanjun Shi (Department of Myxoma, Aerospace Center Hospital, Beijing, 100049, China)
Ying Cai (Department of Myxoma, Aerospace Center Hospital, Beijing, 100049, China)
Yiyan Lu (Department of Pathology, Aerospace Center Hospital, Beijing, 100049, China)
Shaojun Pang (Department of Myxoma, Aerospace Center Hospital, Beijing, 100049, China)
Feng Chen (Department of Myxoma, Aerospace Center Hospital, Beijing, 100049, China)
Hongbin Xu (Department of Myxoma, Aerospace Center Hospital, Beijing, 100049, China)
Ruiqing Ma (Department of Myxoma, Aerospace Center Hospital, Beijing, 100049, China)

Article ID: 2272

Abstract


As more and more centers has published their treatment results ofpseudomyxoma peritonei (PMP) with cytoreductive surgery (CRS) andhyperthermic intraperitoneal chemotherapy (HIPEC), the data from Chinais missing. Myxoma Department of Aerospace Hospital is the biggestcenter treating PMP in China. The purpose of this study is to report theearly and long-term outcomes for PMP from this single center. Methods:801 appendix-derived PMP out of 1008 consecutive patients treated inMyxoma Department of Aerospace Hospital between 2008 and 2019 wereretrospectively analyzed. Results: Complete cytoreductive surgery (CCRS)was achieved in 240 (30%) patients with median PCI of 14(1~39), andthe rest had maximal tumor debulking (MTD), HIPEC was implementedin 96.3% of CCRS and 78.6% of MTD. The major morbidity (gradeIII/IV) was 11.4% and the 30-day operative mortality is 0.7%. The 5-and 10-year OS of CCRS was 76.9% and 64.1%, which is significantlyhigher than MTD (5-, 10-year OS as 36.1%, 27.1%; p<0.001). On theunivariate analysis, all prognostic factors (gender, PSS, interval time, priorchemotherapy, prior HIPEC, Peritoneal Cancer Index (PCI), completenessof cytoreduction (CC), HIPEC, pathology, present of serous ascites) werefound to be associated with overall survival except for age. On multivariateanalysis, only PCI>20, MTD, high pathologic grade and without HIPECwere independent factors predicting poorer prognosis. Conclusions: CCRS+HIPEC can benefit PMP well with controllable risks. MTD+HIPEC maybenefit PMP as well when CCRS cannot be achieved after fully asscessmentby an experienced peritoneal maglignacy center, but the surgery should beperformed as limited as possible.

Keywords


Appendix-derived; Maximal tumor debulking (MTD); CRS; HIPEC; PMP

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References


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DOI: https://doi.org/10.30564/jor.v2i2.2272

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