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Title: Cytoreductive Surgery Plus Hyperthermic Intraoperative Chemotherapy Improves Survival for Patients With Pseudomyxoma Peritonei: Presented at ESSO
URL: http://www.pslgroup.com/dg/22C5FE.htm
Doctor's Guide
September 15, 2008

By Shazia Qureshi

THE HAGUE, Netherlands -- September 15, 2008 -- In patients with pseudomyxoma peritonei, cytoreductive surgery plus hyperthermic intraperitoneal intraoperative chemotherapy (HIPEC) achieves a significantly longer overall survival than debulking surgery plus sequential postoperative intraperitoneal chemotherapy (SPIC).

Pseudomyxoma peritonei is a rare disease that can include various mucus-producing tumours in the abdominal cavity. Left untreated, it can result in abdominal organ failure and death.

Lead author Håkan Andréasson, MD, Department of Surgery, University Hospital Uppsala, Uppsala, Sweden, presented the results of a comparative study on September 12 in a poster session at the 14th Congress of the European Society of Surgical Oncology (ESSO).

Dr. Andréasson and colleagues studied 126 patients with pseudomyxoma peritonei who were scheduled to undergo surgery for peritoneal carcinomatosis from September 1993 to December 2007.

Patients were a mean of 55 years old (range, 21-79 years) and 48% of the cohort were men.

Patients underwent debulking surgery plus SPIC (n = 45) and those treated between October 2003 and December 2007 underwent cytoreductive surgery plus HIPEC (n = 81).

Results showed that patients who underwent cytoreductive surgery plus HIPEC had a 3-year overall survival that was significantly higher than in patients who underwent debulking plus SPIC (79% vs 64%, respectively; P = .01).

In addition, rates of surgical complications that required relaparotomy were statistically similar between the 2 groups (12.3% with cytoreductive surgery plus HIPEC vs 15.5% with debulking plus SPIC; P = .96).

Among all 126 patients, the 3-year overall survival was 71% and the 5-year overall survival was 61%.

R1 resection was achieved in 67 patients (53%) and R2 or more in 59 patients (47%). The 5-year survival rate with an R1 resection was 88%, and with a resection of R2 or more, it was 38% (P = .001).

"Cytoreductive surgery plus HIPEC should be the treatment of choice for pseudomyxoma peritonei," Dr. Andréasson concluded.


[Poster title: What Is the Optional Treatment of Pseudomyxoma Peritonei (PMP)? Abstract 370]

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