title: Comparison of serial debulking and cytoreductive surgery with hyperthermic intraperitoneal chemotherapy in pseudomyxoma peritonei of appendiceal origin.
abstract: OBJECTIVE
  Patients with pseudomyxoma peritonei (PMP) benefit from cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Reports on this modality usually have included only patients with successful HIPEC treatment, which can potentially cause biased results. We report the survival of a PMP population treated by CRS and HIPEC, including patients who were not eligible for HIPEC.
  
  
  METHODS
  The outcome of the whole population of 87 patients with PMP treated by CRS and HIPEC in Helsinki University Central Hospital between 2008 and 2011 was evaluated. The results of treatment were compared with 33 patients treated by serial debulking in our unit between 1984 and 2008.
  
  
  RESULTS
  Of the 87 patients in the HIPEC-era group, 56 received HIPEC, 12 were treated non-radically in an attempt at HIPEC, 9 were debulked and 10 were referred back or transferred to palliative care without surgery. The 5-year overall survival for the debulking-era group and the HIPEC-era group were 67 and 69 %, respectively. The number of patients with no evidence of disease was higher in the HIPEC-era group (47/87) than that in the debulking-era group (8/33) at the end of the follow-up. Overall survival for patients who underwent successful CRS and HIPEC at 2 and 5 years was 95 and 93 %, respectively.
  
  
  CONCLUSIONS
  The improved survival from using the CRS and HIPEC was not apparent after 5-year follow-up, when the whole patient population was included in the analysis. Even so, patients successfully treated by CRS and HIPEC manage well.
authors: Department of Surgery, Meilahti Hospital, Helsinki University Central Hospital, Haartmaninkatu 4, FI-00029, Helsinki, Finland, petrus.jarvinen@hus.fi.
authors: Petrus
authors: P
authors: Järvinen
authors: Ari
authors: A
authors: Ristimäki
authors: Jonas
authors: J
authors: Kantonen
authors: Merja
authors: M
authors: Aronen
authors: Riikka
authors: R
authors: Huuhtanen
authors: Heikki
authors: H
authors: Järvinen
authors: Anna
authors: A
authors: Lepistö
mesh_terms: D000328:Adult; D000368:Aged; D001063:Appendiceal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*; D065426:Cytoreduction Surgical Procedures; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D007274:Injections, Intraperitoneal; D008297:Male; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D011553:Pseudomyxoma Peritonei / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery*