RESUMEN
Pseudomyxoma peritonei (PMP) is a rare clinical syndrome. Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is gradually being accepted as the standard treatment for PMP. At Aerospace Hospital, we have been treating patients with PMP since 2008 and performing total peritoneal resection since 2016. This study summarizes the experience at our center and collates past data. Methods: We performed a retrospective analysis of a prospectively maintained database of all patients who had undergone CRS and HIPEC for PMP at our center. Clinical data, such as the surgical approach, completeness of cytoreduction, and surgical complications, were collected. The results from follow-up were analyzed to simultaneously evaluate the clinical value of CRS+HIPEC and peritonectomy procedures. Results: A total of 854 consecutive patients with PMP were included in the study. Their mean age was 50 years. The median modified peritoneal cancer index (PCI) was 29. Of the patients, 25.5% under-
RESUMEN
Objective: To investigate the value of MSCT in preoperative assessing operitoneal cancer index (PCI) in patients with pseudomyxoma peritonei (PMP). Methods MSCT data of histopathologically proved PMP in 108 patients were retrospectively analyzed. MSCT-PCI scores were evaluated and compared with intraoperative PCI scores, 0-8 was assigned to the omentum area, the liver area, the small omental sac area, the spleen area, the descending colon area, the left iliac area, the pelvic area, the right iliac area and the ascending colon area, respectively, whereas 9 to 12 were assigned to the small intestine area. The consistency between MSCT-PCI scores and the intraoperative PCI scores in different regions and MSCT-PCI scores in different regions between different observers were analyzed. The efficacy of MSCT in diagnosing PMP in different regions was calculated. Results Among 108 patients, the consistency between MSCT-PCI and intraoperative PCI scores in 1-3 regions was good, of 0, 4-9 regions was moderate, while of the 10-12 regions was fair. The consistency of MSCT-PCI scores in 0, 4 and 7 regions between 2 observers was better, of 1-3, 5, 8-10 regions was good, of 6, 11, 12 regions was moderate. The sensitivity of MSCT in diagnosis of PMP in 0-12 regions was 92.63% (88/95), 97.94% (95/97), 95.83% (92/96), 95.79% (91/95), 89.69% (87/97), 95.00% (95/100), 96.08% (98/102), 96.12% (99/103), 94.90% (93/98), 87.78% (79/90), 88.89% (80/90), 86.17% (81/94) and 85.71% (84/98); the specificity was 84.62% (11/13), 100% (11/11), 91.67% (11/12), 84.62% (11/13), 100% (11/11), 87.50% (7/8), 83.33% (5/6), 100% (5/5), 100% (10/10), 83.33% (15/18), 83.33% (15/18), 85.71% (12/14) and 80.00% (8/10); and the accuracy was 91.67% (99/108), 98.15% (106/108), 95.37% (103/108), 94.44% (102/108), 90.74% (98/108), 94.44% (102/108), 95.37% (103/108), 96.30% (104/108), 95.37% (103/108), 87.04% (94/108), 87.96% (95/108), 86.11% (93/108) and 85.19% (92/108). Conclusion MSCT can accurately assess PCI of PMP, therefore providing references for clinical development of treatment plan.