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Objective: To analyze the clinical outcomes of pseudomyxoma peritonei(PMP) originating from the appendix following cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Methods: A retrospective study was carried out by analyzing clinical data of patients who diagnosed with PMP originating from appendix and had undergone CRS and HIPEC between January 2012 and December 2018. Results: A total of 604 patients had undergone 621 CRS and HIPEC procedures. The average age of the patients was 56.7 years. Of the patients, 364 (60.3%) were female and 240 (39.7%) were male. The median peritoneal carcinomatosis index (PCI) was 25.7. Of the patients, 28.5% (172/604) had undergone complete cytoreduction (CCR 0/1). In this study, the incidence of grade 3-4 adverse events was 21.7% (131/604), and the perioperative mortality rate was 0.7% (4/604). For the entire cohort, the 5-year survival rate was 53.6%. High-grade pathological subtype CCR 2/3, PCI >20, and grade 3-4 adverse events were independent predictors of a poor overall survival. Conclusions: Appendix-derived PMP is rare, and its treatment should be considered carefully. For patients who are suspected or are confirmed as PMP, early standardized CRS and HIPEC are related to a better prognosis.
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Objective@#To analyze the efficacy and safety of cytoreduction surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) for pseudomyxoma peritonei (PMP) in the early stage.@*Methods@#The clinical data, including pathological features, recurrence and survival of 65 PMP patients in the early stage underwent CRS combined with HIPEC in Aerospace Center Hospital from January, 2011 to December, 2018 were retrospectively analyzed.@*Results@#65 patients with early stage PMP underwent CRS+ HIPEC. Among these patients, 25 were males and 40 were females, and the mean age was 52.5 years. The median peritoneal cancer index was 3 (0-16). The score of completeness of cytoreduction (CC) of 63 patients (96.9%) was 0, and 2 patients (3.1%) was 1. No perioperative death occurred, the incidence of surgical complications above grade 3 was 3.1%. Three patients relapsed during the follow-up period, including 1 patient with low-grade PMP, 1 patient with high-grade PMP, and 1 patient with high-grade PMP accompanied by signet ring cell. The 5-year disease-free survival rate of the whole group was 92.4%.@*Conclusions@#PMP patients in the early stage treated by CRS combined with HIPEC can achieve benefit and safety. A close long-term follow-up is necessary.
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Objective: To investigate the clinicopathological features and treatment strategy of pseudomyxoma peritonei (PMP) of ex-tra-appendiceal origin. Methods: Clinical data of 34 patients diagnosed with PMP of extra-appendiceal origin who were treated by cy-toreduction surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in the Aerospace Center Hospital from September 2011 to February 2019 were retrospectively analyzed. Clinical and imaging features were summarized and the Log-rank test was used for survival analysis. Results: The clinical manifestations of the 34 patients with PMP of extra-appendiceal origin were mainly abdomi-nal distension (58.8%) and abdominal pelvic mass (52.9%), which are very similar to those of appendiceal PMP. The incidence of main complications after CRS and HIPEC was 14.7%. During the follow-up period of a median of 12 months (range 1-46 months), 9 patients died, and the 1-and 3-year overall survival rates were 69.6% and 53.5%, respectively. In the univariate analysis, peritoneal cancer in-dex (PCI)>20, no HIPEC, and non-radical surgery were significant risk factors for poor prognosis, while gender, age, origin, and patho-logical type did not show significant correlations. Conclusions: The clinical features of PMP of extra-appendiceal origin are not differ-ent to those of PMP originating from the appendix. It is difficult to ascertain the primary lesion before the operation; however, regard-less of the origin, CRS combined with HIPEC is always a safe and effective treatment choice.