TITLE:
Outcome of Management of Pseudomyxoma Peritonei: National Cancer Institute Experience
AUTHORS:
Z. Gad, O. Nassar, H. Soliman, S. Mohamed, M. Mohamed
KEYWORDS:
HIPEC, NCI Experience, Pseudomyxoma Peritonii
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.9 No.4,
April
27,
2018
ABSTRACT: Background: The current treatment for pseudomyxoma peritonei (PMP) consists of
radical cytoreductive surgery (CRS) followed by hyperthermic intra-peritoneal
chemotherapy (HIPEC). Aim: To assess PMP patients regarding the
clinical and pathological characteristics, the treatment including surgery
(CRS) and chemotherapy either HIPEC type or post-operative systemic
chemotherapy aiming to evaluate end results regarding recurrence and survival. Patients
and Methods: This retrospective study included 39 patients with PMP who
were diagnosed, treated and followed-up from 2009-2014 at National Cancer
Institute, Cairo, Egypt. Results: High grade mucinous adenocarcinoma was
found in 23.1% of patients. Patients with low grade tumor showed higher
survival rate compared with patients with high grade disease. The mean
operative PCI score (peritoneal cancer index) that was done to all patients who
were explored was 15.81. Our study reported success to achieve complete
cytoreduction that was combined with HIPEC in 44% of patients who were planned
for this modality. Treatment related postoperative grade (3 - 5) complications
mainly surgery related developed in 17.3 of patients. Operative mortality was
22.2%. The follow up period in our study was quite short (mean 22.9). However
the overall survival at the end of the follow up in our study was 48.7%, 1 year
survival was 82%, and 2 year survival was 41%. The overall survival in patients
treated with CRS and HIPEC was 66.6%, with 1 year and 2 year survival of 91%
and 66.6% respectively. Only 2 patients developed recurrent disease during the
follow up period. Conclusions: The outcome of PMP treatment process is
extremely variable. Combined CRS and HIPEC is considered the best therapeutic
approach for patients with PMP. Surgical experience combined with proper
patient selection have to be built up together to improve the outcome. That
could only be achieved through more centralization of patients’ treatment in
specialized units or center.