Ultrasound-guided intraperitoneal cisplatin after the maximum cytoreductive surgery of pseudomyxoma peritonei

ABSTRACT

In the past, pseudomyxoma peritonei was considered an incurable disease and often no active treatment was given. With the advent of cyto-reductive surgery, including peritonectomy procedures and intra peritoneal chemotherapy, long-term survival of these patients became actually possible. To study the impact of the intraperitoneal hyperthermic chemotherapy [cisplatin], when locally administered in patients who presented with pseudomyxoma peritonei and were treated by extensive cyto-reductive surgery. Nine patients with and. peritoneal adenomucinosis or carcinomatosis arising from the appendix who presented with a clinical picture of pseudomyxoma peritonei were diagnosed, and treated by cyto-reductive surgery followed by 6 cycles of ultrasound-guided intraperitoneal hyperthermic cisplatin. Following aggressive surgical approach and intraperitoneal chemotherapy, 7 patients had 1 year disease free survival, achieved independent activity in daily living and had an improved quality of life. The other 2 patients developed recurrences at 8 and 10 months following the completion of treatment. No major [grade III] texicities were observed. Pseudomyxoma peritonei is a treatable condition that may result in long-term disease free survival. Successful management can be achieved by combining cyto-reductive surgery and intraperitoneal hyperthermic chemotherapy