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Cytoreductive Surgery With Intraperitoneal Chemohyperthermia for the Treatment of Pseudomyxoma Peritonei: A Prospective Study

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Diseases of the Colon & Rectum

PURPOSE

Pseudomyxoma peritonei is a rare disease. Recently, cytoreductive surgery with intraperitoneal hyperthermic chemotherapy has emerged as a promising treatment for this debilitating condition. The aim of this prospective study was to evaluate this treatment strategy.

METHOD

Twenty-seven patients with pseudomyxoma peritonei who were treated by cytoreductive surgery and intraperitoneal chemohyperthermia between 1997 and 2003 were identified from a prospective database.

RESULTS

Clinical presentation included suspected appendicitis (33 percent), increased abdominal girth (30 percent), and a suspected ovarian mass (26 percent). Twenty-two patients underwent surgery elsewhere before referral. Seventeen complications occurred in 12 patients (44 percent). Six were considered major: three anastomotic leaks, two pleural effusions, and one intra-abdominal abscess. Histologic examination demonstrated Grade 1, 2, and 3 disease in 8 (30 percent), 10 (37 percent), and 9 patients (33 percent), respectively. Pathologic grade showed a significant influence on the complication rate (P = 0 0.008). The actuarial five-year survival was 100 percent for patients with Grade 1 disease, whereas actuarial one-, two-, three-, and five-year survival for Grades 2 and 3 were 100, 80, 64, and 32 percent, respectively (P = 0.008).

CONCLUSIONS

Cytoreductive surgery with intraperitoneal hyperthermic chemotherapy is a feasable treatment for pseudomyxoma peritonei. It is associated with acceptable morbidity when performed by an experienced surgical team. Histologic grade is the major determinant of survival.

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Authors and Affiliations

  1. Department of Colon and Rectum Surgery, Centre Hospitalier de l’Université de Montréal, Hôpital Saint-Luc, Montréal, Québec, Canada

    Rasmy Loungnarath M.D.

  2. Department of Digestive Surgery, Dijon Cancer Center, Dijon, France

    Sylvain Causeret M.D.

  3. Department of Biostatistics, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France

    Nadine Bossard M.D., Ph.D.

  4. Department of General Surgery, University of Newcastle upon Tyne, Newcastle upon Tyne, United Kingdom

    Mohamed Faheez M.B.Ch.B., M.R.C.S.

  5. Department of Anesthesiology, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France

    Annie-Claude Sayag-Beaujard M.D.

  6. Department of General Surgery, Centre Hospitalier Universitaire de Strasbourg, Strasbourg, France

    Cécile Brigand M.D.

  7. Department of General, Thoracic and Endocrine Surgery, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France

    François Gilly M.D., Ph.D., & Olivier Glehen M.D., Ph.D.

  8. Faculté de Médecine Lyon-Sud, Université Claude Bernard Lyon 1, Oullins, France

    François Gilly M.D., Ph.D., & Olivier Glehen M.D., Ph.D.

Authors
  1. Rasmy Loungnarath M.D.
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  2. Sylvain Causeret M.D.
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  3. Nadine Bossard M.D., Ph.D.
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  4. Mohamed Faheez M.B.Ch.B., M.R.C.S.
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  5. Annie-Claude Sayag-Beaujard M.D.
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  6. Cécile Brigand M.D.
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  7. François Gilly M.D., Ph.D.,
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  8. Olivier Glehen M.D., Ph.D.
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Corresponding author

Correspondence to Olivier Glehen M.D., Ph.D..

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Loungnarath, R., Causeret, S., Bossard, N. et al. Cytoreductive Surgery With Intraperitoneal Chemohyperthermia for the Treatment of Pseudomyxoma Peritonei: A Prospective Study. Dis Colon Rectum 48, 1372–1379 (2005). https://doi.org/10.1007/s10350-005-0045-5

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  • DOI: https://doi.org/10.1007/s10350-005-0045-5

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