INTRAPERITONEAL 5-FLUOROURACIL FOR PSEUDOMYXOMA PERITONEII

Pseudomyxoma peritoneii has an indolent course but a 5-year survival r ate of 40-45%. The role for postoperative intraperitoneal chemotherapy is unclear. Nine patients with pseudomyxoma arising from mucinous neo plasms of the ovary and intestinal tract received a total of 89 course s of intraperitoneal 5-fluorouracil (IP5FU). Each course consisted of eight 4-h exchanges of Ig of 5FU in 21 of 1.5% Inpersol(R). Median fol low-up after diagnosis was 30 months (range 6-74). All patients were e valuable for toxicity and response. There was one treatment-related de ath due to renal failure and sepsis. Three patients developed disease progression prior to scheduled second-look laparotomy. At second-look laparotomy two patients demonstrated pathologic complete responses, on e had stable disease and one had progression of disease. One patient r emained clinically free of progression after refusing second-look lapa rotomy. The projected 5-year survival by Kaplan-Meier estimate was 87% for patients treated with IP5FU compared to a 52% 5-year survival see n in a series of 11 patients treated prior to the use of IP5FU (P = 0. 12). This preliminary analysis suggests that IPFU in the described sch edule fails to improve survival statistically compared to previously u sed regimens for patients with pseudomyxoma peritoneii.