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.