Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for pseudomyxoma peritonei of appendicular and extra-appendicular origin

Nom de la revue
British Journal of Surgery
J-B Delhorme, F Severac, G Averous, O Glehen, G Passot, N Bakrin, F Marchal, M Pocard, R Lo Dico, C Eveno, S Carrere, O Sgarbura, F Quenet, G Ferron, D Goéré, C Brigand, J Abba, K Abboud, M Alyami, C Arvieux, G Averous, N Bakrin, G Balagué, V Barrau, H Ben Rejeb, J-M Bereder, I Berton-Rigaud, F Bibeau, I Bonnefoy, D Bouzard, I Bricault, C Brigand, S Carrère, C de Chaisemartin, M Chassang, A Chevallier, T Courvoisier, P Dartigues, A Dohan, J Dubreuil, F Dumont, C Eveno, M Faruch-Bilfeld, G Ferron, J Fontaine, L Fournier, J Gagniere, D Geffroy, L Ghouti, F-N Gilly, L Gladieff, O Glehen, D Goéré, A Guibal, J-M Guilloit, F Guyon, B Heyd, C Hoeffel, C Hordonneau, S Isaac, P Jourdan-Enfer, R Kaci, R Kianmanesh, C Labbé-Devilliers, J Lacroix, B Lelong, A Leroux-Broussier, Y Lherm, R Lo Dico, G Lorimier, C Malhaire, F Marchal, P Mariani, E Mathiotte, P Meeus, E Mery, S Msika, C Nadeau, P Ortega-Deballon, G Passot, O Pellet, P Peyrat, D Pezet, N Pirro, M Pocard, F Poizat, J Porcheron, A Poulet, F Quenet, P Rat, P Rousselot, P Rousset, H Senellart, M Serrano, V Servois, O Sgabura, A Skanjeti, M Svrcek, R Tetreau, E Thibaudeau, Y Touchefeu, J-J Tuech, S Valmary-Degano, D Vaudoyer, S Velasco, V Verriele-Beurrier, L Villeneuve, R Wernert, F Zinzindohoue

AbstractBackgroundThe prognostic value of the primary neoplasm responsible for pseudomyxoma peritonei (PMP) remains poorly studied. The aim of this study was to determine the prognosis for patients with extra-appendicular PMP (EA-PMP) treated optimally with complete cytoreductive surgery (CCRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).MethodsAll patients treated for PMP with CCRS and HIPEC between 1994 and 2016 were selected retrospectively from a French multicentre database. Patients with EA-PMP had pathologically confirmed non-neoplastic appendices and were matched in a 1 : 4 ratio with patients treated for appendicular PMP (A-PMP), based on a propensity score.ResultsSome 726 patients were identified, of which 61 (EA-PMP group) were matched with 244 patients (A-PMP group). The origins of primary tumours in the EA-PMP group included the ovary (45 patients), colon (4), urachus (4), small bowel (1), pancreas (1) and unknown (6). The median peritoneal carcinomatosis index was comparable in EA-PMP and A-PMP groups (15·5 versus 18 respectively; P = 0·315). In-hospital mortality (3 versus 2·9 per cent; P = 1·000) and major morbidity 26 versus 25·0 per cent; P = 0·869) were also similar between the two groups. Median follow-up was 66·9 months. The 5-year overall survival rate was 87·8 (95 per cent c.i. 83·2 to 92·5) per cent in the A-PMP group and 87 (77 to 96) per cent in the EA-PMP group. The 5-year disease-free survival rate was 66·0 (58·7 to 73·4) per cent and 70 (53 to 83) per cent respectively.ConclusionOverall and disease-free survival following treatment with CCRS and HIPEC is similar in patients with pseudomyxoma peritonei of appendicular or extra-appendicular origin.