Ten years experience in the treatment of pseudomyxoma peritonei by cytoreduction, peritonectomy and semi-closed hyperthermic antiblastic peritoneal perfusion.
BACKGROUND
In the literature good results have been reported for the treatment of Pseudomyxoma peritonei (PMP) by cytoreduction, peritonectomy and hyperthermic antiblastic peritoneal perfusion (H.A.P.P.). Forty-eight patients affected by PMP have been treated with this technique over the past ten years.


METHODS
Peritoneal perfusion has been performed with the original semiclosed tecnique after complete surgical cytoreduction in 188 patients affected by peritoneal carcinomatosis. In 48 of the cases the patients were affected from PMP. Aggressive surgical cytoreduction was performed with multiple visceral resections and peritonectomies.


RESULTS
Seventeen patients (38%) presented major perioperative complications, and in five cases the reoperation of the patient was required. In spite of this high complication rate, there was no perioperative mortality. The results of the Kaplan-Meier 5- and 10-year survival analysis, were 94% and 82%, respectively, with a disease-free survival of 80% at 5 years and 70% at 10 years. Thirty-nine patients (81.2%) had no evidence of disease at follow-up (range 1-120 months).


CONCLUSIONS
Up to date, the most effective treatment for PMP has been aggressive cytoreduction plus H.A.P.P.
De Simone
M
M
General and Oncological Surgery Department, V.le Boccaccio 12, 50053-Empoli, Florence, Italy. mdesi1@inrete.it
Vaira
M
M
Caponi
A
A
Ciaccio
B
B
Fiorentini
G
G
Turrisi
G
G
Ferri
L
L
Buti
G
G
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D010478:Chemotherapy, Cancer, Regional Perfusion; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000628:therapy*; D010537:Peritoneum / Q000601:surgery*; D011553:Pseudomyxoma Peritonei / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate