Thoracic cytoreductive surgery and intraoperative hyperthermic intrathoracic chemotherapy for pseudomyxoma peritonei.
BACKGROUND
Pleural dissemination of pseudomyxoma peritonei (PMP) is considered an advanced/terminal disease. We review our experience with thoracic cytoreductive surgery (CRS) and intraoperative hyperthermic intrathoracic chemotherapy (HITHOC) for the treatment of pleural recurrence of PMP following previous intraabdominal surgery.


METHODS
An observational study of five patients with pleural dissemination from PMP treated with thoracic CRS and intraoperative HITHOC with mitomycin C for 90 min at 41.5 degrees C.


RESULTS
There were three men. The mean age was 46.5 (10.5) years. Postoperatively, one patient developed Grade I, one patient developed Grade III and one patient developed Grade IV postoperative complication. Two patients had an unremarkable postoperative recovery. Only one patient has died 38 months since treatment from abdominal complication of this disease with no evidence of thoracic disease. The four surviving patients are still alive 4.6-47.4 months after treatment. Two patients have evidence of an intraabdominal recurrence.


CONCLUSIONS
Thoracic CRS and intraoperative HITHOC is a safe and effective procedure to treat pleural dissemination from PMP. Long-term disease-free survival can be achieved from this treatment for which no other potentially curative therapy has been described.
Chua
Terence C
TC
Department of Surgery, University of New South Wales, St George Hospital, Kogarah, Sydney, NSW, Australia.
Yan
Tristan D
TD
Yap
Zhu L
ZL
Horton
Matthew D
MD
Fermanis
Gary G
GG
Morris
David L
DL
D000368:Aged; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D007432:Intraoperative Period; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010534:Peritoneal Neoplasms / Q000628:therapy*; D011553:Pseudomyxoma Peritonei / Q000628:therapy*; D012086:Reoperation; D013908:Thoracotomy; D016896:Treatment Outcome