title: Chemo-hyperthermic peritoneal perfusion (CHPP) for appendiceal pseudomyxoma peritonei.
abstract: BACKGROUND
  Pseudomyxoma peritonei is derived mostly from the rupture of an appendiceal cystic tumor and produces a large quantity of mucinous substance. Though its malignancy level is low, radical resection is difficult and its prognosis is poor. In some institutes in European countries and the United States, multidisciplinary treatment with chemo-hyperthermia at a relatively low temperature is performed following subtotal peritonectomy. We carried out high-temperature chemo-hyperthermic peritoneal perfusion following incomplete resections of mucinous tumors in six patients.
  
  
  METHODS
  After resection of the main tumor and macroscopic gross tumor resection of dissemination, heated perfusate containing anticancer agents was poured into the peritoneal cavity and stirred and pumped into a circulation between the abdomen and a reservoir. The temperature of the surface of the peritoneum was maintained at around 43 degrees C.
  
  
  RESULTS
  The intraperitoneal space was sufficiently heated without severe complications. The pathological diagnosis in four of the patients was peritoneal mucinous carcinomatosis, and in the other two patients, it was intermediate type between peritoneal mucinous carcinomatosis and disseminated peritoneal adenomucinosis. Two patients died, 15 and 26 months after the treatment. The other four patients have survived for 4, 24, 26, and 80 months now, and two of them, who have survived for 26 and 80 months, received a second treatment 18 and 32 months, respectively, after the initial treatment. These results seemed not to be inferior to those in the reports from institutes in Europe and the United States which performed subtotal peritonectomy and then used mild hyperthermia in chemo-hyperthermia.
  
  
  CONCLUSIONS
  For treating pseudomyxoma peritonei, high-temperature chemo-hyperthermic peritoneal perfusion following incomplete tumor resection is effective even without peritonectomy.
authors.affiliation: First Department of Surgery, University of Fukui, School of Medicine, 23 Shimoaizuki, Matsuoka, Eiheiji-cho, Fukui, 910-1193, Japan. kanji@u-fukui.ac.jp
authors.forename: Kanji
authors.initials: K
authors.lastname: Katayama
authors.forename: Akio
authors.initials: A
authors.lastname: Yamaguchi
authors.forename: Makoto
authors.initials: M
authors.lastname: Murakami
authors.forename: Kenji
authors.initials: K
authors.lastname: Koneri
authors.forename: Hideki
authors.initials: H
authors.lastname: Nagano
authors.forename: Kei
authors.initials: K
authors.lastname: Honda
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Hirono
authors.forename: Takanori
authors.initials: T
authors.lastname: Goi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Iida
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ito
mesh_terms: D000368:Aged; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D008297:Male; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D011553:Pseudomyxoma Peritonei / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D014057:Tomography, X-Ray Computed