Intraperitoneal 5-fluorouracil for pseudomyxoma peritoneii.
Pseudomyxoma peritoneii has an indolent course but a 5-year survival rate of 40-45%. The role for postoperative intraperitoneal chemotherapy is unclear. Nine patients with pseudomyxoma arising from mucinous neoplasms of the ovary and intestinal tract received a total of 89 courses of intraperitoneal 5-fluorouracil (IP5FU). Each course consisted of eight 4-h exchanges of 1 g of 5FU in 2 l of 1.5% Inpersol(R). Median follow-up after diagnosis was 30 months (range 6-74). All patients were evaluable for toxicity and response. There was one treatment-related death 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, one had stable disease and one had progression of disease. One patient remained clinically free of progression after refusing second-look laparotomy. The projected 5-year survival by Kaplan-Meier estimate was 87% for patients treated with IP5FU compared to a 52% 5-year survival seen 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 schedule fails to improve survival statistically compared to previously used regimens for patients with pseudomyxoma peritoneii.
Look
K.Y.
KY
Department of Obstetrics and Gynecology, Section Gynecologic Oncology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Stehman
F.B.
FB
Moore
D.H.
DH
Sutton
G.P.
GP