Extensive surgical cytoreduction and intraoperative hyperthermic intraperitoneal chemotherapy in patients with pseudomyxoma peritonei

Citation
Aj. Witkamp et al., Extensive surgical cytoreduction and intraoperative hyperthermic intraperitoneal chemotherapy in patients with pseudomyxoma peritonei, BR J SURG, 88(3), 2001, pp. 458-463
Citations number
28
Categorie Soggetti
Surgery,"Medical Research Diagnosis & Treatment
Journal title
BRITISH JOURNAL OF SURGERY
ISSN journal
00071323 → ACNP
Volume
88
Issue
3
Year of publication
2001
Pages
458 - 463
Database
ISI
SICI code
0007-1323(200103)88:3<458:ESCAIH>2.0.ZU;2-3
Abstract
Background: Pseudomyxoma peritonei remains a fatal disease. However, extens ive surgical cytoreduction combined with intraoperative heated intraperiton eal chemotherapy (HIPEC) has recently emerged as a new treatment modality, which might improve survival. Methods: Patients underwent treatment if the tumour appeared to be technica lly resectable on preoperative abdominal computed tomography and there were no distant metastases. After aggressive surgical cytoreduction, HIPEC with the administration of mitomycin C was performed for 90 min. Depending on h istological grading, patients received adjuvant 5-fluorouracil and leucovor in therapy. Results: Forty-six patients were treated. Optimal surgical cytoreduction wa s obtained in 40 patients. Postoperative surgical complications occurred in 18 patients. Four patients died as a direct result of the treatment. Bone marrow suppression due to mitomycin C toxicity occurred in 22 patients. The re was no other major toxicity related to the HIPEC procedure. After a medi an follow-up of 12 months, 40 patients are alive, eight of whom have proven recurrence. The actuarial survival rate (Kaplan-Meier) at 3 years was 81 p er cent. Conclusion: These results confirm that extensive surgery combined with HIPE C is feasible in patients with pseudomyxoma peritonei and that improved lon g-term survival might be achieved.