Intraperitoneal hyperthermia in the management of pseudomyxoma peritonei.
OBJECTIVE
Pseudomyxoma peritonei is a rare disease characterized by diffuse intraperitoneal mucinous tumor and massive mucinous ascites. The mainstay of treatment is surgery in combination with adjuvant therapy.


METHODS
From 1995 to 2002, 8 patients with pathologically confirmed pseudomyxoma peritonei were studied. After surgical debulking, intraoperative intraperitoneal hyperthermia was performed followed by 5 days of postoperative intraperitoneal hyperthermia. Normal saline at 46 C was used for hyperthermia. Patients were followed for clinical data, survival, morbidity, and mortality.


RESULTS
The appendix was the origin of pseudomyxoma peritonei in 6 patients, the ovary in 1 patient, and the fallopian tube in another. The pathologic diagnosis was mucinous adenocarcinoma in 4 patients, mucinous cystadenocarcinoma in 3, and mucinous cystadenoma in 1. Associated morbidity and mortality was 12.5% and 0, respectively. The recurrence rate was 62.5%, with a median follow-up of 52.5 months. The estimated 1-, 3-, and 5-year survival rates were 100%, 88%, and 49%, respectively.


CONCLUSIONS
Surgical debulking followed by 46 C normal saline intraperitoneal hyperthermia resulted in a 5-year survival of 49% with low morbidity and no mortality for the treatment of pseudomyxoma peritonei. We concluded that this is an easy, safe, and efficacious treatment for patients with this rare disease.
Hsu
Kai-Hsi
KH
Department of Surgery, National Cheng Kung University Hospital, College of Medicine, Tainan, Taiwan.
Chou
Cheng-Yang
CY
Chang
Yu-Chung
YC
D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D018282:Cystadenocarcinoma, Mucinous / Q000473:pathology; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D011553:Pseudomyxoma Peritonei / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D012189:Retrospective Studies
D014408:Biomarkers, Tumor