Advertisement

Annals of Surgical Oncology

, Volume 26, Issue 1, pp 238–243 | Cite as

Patient Survival after Surgical Management in Intrathoracic Pseudomyxoma peritonei

  • Yo KawaguchiEmail author
  • Jun Hanaoka
  • Yasuhiko Ohshio
  • Keigo Okamoto
  • Ryosuke Kaku
  • Kazuki Hayashi
  • Takuya Shiratori
  • Makoto Yoden
Thoracic Oncology
  • 41 Downloads

Abstract

Background

Pseudomyxoma peritonei (PMP) is a rare disease, characterized by mucinous ascites and deposits diffusely present on the peritoneal surfaces. However, extension of PMP to the thoracic cavity is extremely rare. Although there are a few case reports on the long-term postoperative prognosis of intrathoracic lesions, whether surgical resection of these lesions can improve patient prognosis remains unclear.

Methods

We reviewed 17 patients with PMP who underwent resection of intrathoracic lesions after abdominal cytoreductive surgery and examined their clinical outcome after surgery.

Results

Direct extension into the pleural cavity was identified in 11 patients. Extrapleural pneumonectomy of the lesions followed by hyperthermic intrathoracic chemotherapy (HITOC) was performed in four patients, parietal pleurectomy and visceral tumor resection followed by HITOC in four patients, resection of all disseminated pleural and visceral lesions followed by HITOC in one patient, resection of a single disseminated lesion in one patient, and composite resection of basal segment with the diaphragm in one patient. Pulmonary metastases were found in six patients. Partial resection was performed in four patients, segmentectomy in one patient, and lobectomy in one patient. We could perform macroscopic resection of the tumor in all the cases. The 5-year overall survival rate after thoracic surgery for the 17 patients was 46.1% and relapse-free survival was 34.9%.

Conclusions

Resection of intrathoracic lesions of PMP after abdominal cytoreductive surgery achieved 5 years survival in at least 46.1% of the patients. Aggressive tumor resection should be considered for patients with PMP extending to thoracic cavity.

References

  1. 1.
    Sugarbaker PH. Comprehensive management of peritoneal surface malignancy using cytoreductive surgery and perioperative intraperitoneal chemotherapy: the Washington Cancer Institute approach. Expert Opin Pharmacother. 2009;10:1965–77.CrossRefGoogle Scholar
  2. 2.
    Pestieau SR, Esquivel J, Sugarbaker PH. Pleural extension of mucinous tumor in patients with pseudomyxoma peritonei syndrome. Ann Surg Oncol. 2000;7:199–203.CrossRefGoogle Scholar
  3. 3.
    Ababneh R, Piso P, Hofmann HS, Dumitrovici A, Buiga R, Samasca G, Burz C. An invasive treatment of pseudomyxoma peritonei with intrathoracic involvement. Maedica (Buchar). 2016;11:72–5.Google Scholar
  4. 4.
    Carr NJ, Finch J, Ilesley IC, et al. Pathology and prognosis in pseudomyxoma peritonei: a review of 274 cases. J Clin Pathol. 2012;65:919–23.CrossRefGoogle Scholar
  5. 5.
    Miner TJ, Shia J, Jaques DP, Klimstra DS, Brennan MF, Coit DG. Long-term survival following treatment of pseudomyxoma peritonei: an analysis of surgical therapy. Ann Surg. 2005;241:300–8.CrossRefGoogle Scholar
  6. 6.
    Hill J, Rafeeq D, Rice D, et al. Clinicopathological characteristics of patients with appendiceal adenocarcinoma and intrathoracic metastasis. In Proceedings of the 7th International Symposium on Regional Cancer Therapies, Fla, USA, February 2012.Google Scholar
  7. 7.
    Mizumoto A, Canbay E, Hirano M, Takao N, Matsuda T, Ichinose M, Yonemura Y. Morbidity and mortality outcomes of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy at a single institution in Japan. Gastroenterol Res Pract.  https://doi.org/10.1155/2012/836425 [Epub 2012 Jun 18].
  8. 8.
    Mortman KD, Sugarbaker PA, Shmookler BM, DeGzman VC, Soberman MS. Pulmonary metastasis in pseudomyxoma peritonei syndrome. Ann Thorac Surg. 1997;64:1434–6.CrossRefGoogle Scholar
  9. 9.
    Geisinger KR, Levine EA, Shen P, Bradley RF. Pleuropulmonary involvement in pseudomyxoma peritonei. Morphologic assessment and literature review. Am J Clin Pathol. 2007;127:135–43.CrossRefGoogle Scholar
  10. 10.
    Kitai T. Pulmonary metastasis from pseudomyxoma peritonei. Gastroenterol Res Pract.  https://doi.org/10.1155/2012/690256. [Epub 2012 Jul 12].
  11. 11.
    Senthil M, Harrison LE. Simultaneous bicavitary hyperthermic chemoperfusion in the management of pseudomyxoma peritonei. Arch Surg. 2009;144:970–2.CrossRefGoogle Scholar
  12. 12.
    Saladino E, Famulari C, Monaca EL, Fortugno A, Fleres F, Macri A. Cytoreductive surgery plus bicavitary chemohyperthermia as treatment of Pseudomixoma peritonei with pleural extension. Ann Ital Chir. 2014;85:372–6.Google Scholar

Copyright information

© Society of Surgical Oncology 2018

Authors and Affiliations

  • Yo Kawaguchi
    • 1
    • 2
    Email author
  • Jun Hanaoka
    • 1
  • Yasuhiko Ohshio
    • 1
  • Keigo Okamoto
    • 1
  • Ryosuke Kaku
    • 1
  • Kazuki Hayashi
    • 1
  • Takuya Shiratori
    • 1
  • Makoto Yoden
    • 1
  1. 1.Division of General Thoracic Surgery, Department of SurgeryShiga University of Medical ScienceShigaJapan
  2. 2.Division of General Thoracic SurgeryKusatsu General HospitalShigaJapan

Personalised recommendations