title: Primary peritonectomy/HIPEC for disseminated peritoneal adenomucinosis achieves much lower recurrence rates and better survival than secondary procedures.
abstract: BACKGROUND
  Two main treatment options are available for pseudomyxoma peritonei (PMP) and disseminated peritoneal adenomucinosis (DPAM)--incomplete cytoreductive (debulking) surgery and peritonectomy with intraperitoneal chemotherapy. Several studies have demonstrated improved survival with peritonectomy. This study analyses outcome following peritonectomy in patients undergoing a primary procedure compared to those who have had previous debulks.
  
  
  METHODS
  Between April 1997 and May 2008, 63 patients underwent peritonectomy for DPAM--38 had had previous debulk(s) and 25 underwent primary peritonectomy. Patients were followed-up at three- to six-monthly intervals postoperatively, with a mean follow-up time of 21 and 34 months, respectively.
  
  
  RESULTS
  Mean survival for patients undergoing primary peritonectomy was 109.8 months. Mean survival for patients with previous debulks was 49.2 months (p=0.027). Five-year survival was 95.5% in the primary peritonectomy group and 67.5% in the previous debulk group.
  
  
  CONCLUSIONS
  Disease recurrence after primary peritonectomy for DPAM is significantly less frequent than after secondary peritonectomy.
authors.affiliation: The University of New South Wales, Department of Surgery, St. George Hospital, Sydney, New South Wales, Australia.
authors.forename: K J
authors.initials: KJ
authors.lastname: Zhu
authors.forename: D L
authors.initials: DL
authors.lastname: Morris
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010529:Peritoneal Cavity / Q000601:surgery; D010534:Peritoneal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011553:Pseudomyxoma Peritonei / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D055815:Young Adult