Cytoreductive surgery with intraperitoneal chemohyperthermia for the treatment of Pseudomyxoma peritonei: A prospective study

被引:85
作者
Loungnarath, R
Causeret, S
Bossard, N
Faheez, M
Sayag-Beaujard, AC
Brigand, C
Gilly, F
Glehen, O [1 ]
机构
[1] Ctr Hosp Lyon Sud, Dept Chirurg Gen Thorac & Endocrinienne, F-69495 Pierre Benite, France
[2] CHU Montreal, Hop St Luc, Dept Colon & Rectum Surg, Montreal, PQ, Canada
[3] Dijon Canc Ctr, Dept Digest Surg, Dijon, France
[4] Ctr Hosp Lyon Sud, Dept Biostat, F-69495 Pierre Benite, France
[5] Univ Newcastle Upon Tyne, Dept Gen Surg, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, England
[6] Ctr Hosp Lyon Sud, Dept Anesthesiol, F-69495 Pierre Benite, France
[7] CHU Strasbourg, Dept Gen Surg, F-67000 Strasbourg, France
[8] Univ Lyon 1, Fac Med Lyon Sud, F-69622 Villeurbanne, France
关键词
Pseudomyxoma peritonei; intraperitoneal chemotherapy; hyperthermia; cytoreductive surgery;
D O I
10.1007/s10350-005-0045-5
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
PURPOSE: Pseudomyxoma peritonei is a rare disease. Recently, cytoreductive surgery with intraperitoneal by hyperthermic chemotherapy has emerged as a promising treatment for this debilitating condition. The aim of this prospective study was to evaluate this treatment strategy. METHOD: Twenty-seven patients with pseudomyxoma peritonei who were treated by cytoreductive surgery and intraperitoneal chemohyperthermia between 1997 and 2003 were identified from a prospective database. RESULTS: Clinical presentation included suspected appendicitis (33 percent), increased abdominal girth (30 percent), and a suspected ovarian mass (26 percent). Twenty-two patients underwent surgery elsewhere before referral. Seventeen complications occurred in 12 patients (44 percent). Six were considered major: three anastomotic leaks, two pleural effusions, and one intra-abdominal abscess. Histologic examination demonstrated Grade 1, 2, and 3 disease in 8 (30 percent), 10 (37 percent), and 9 patients (33 percent), respectively. Pathologic grade showed a significant influence on the complication rate (P = 0 0.008). The actuarial five-year survival was 100 percent for patients with Grade 1 disease, whereas actuarial one-, two-, three-, and five-year survival for Grades 2 and 3 were 100, 80, 64, and 32 percent, respectively (P = 0.008). CONCLUSIONS: Cytoreductive surgery with intraperitoneal hyperthermic chemotherapy is a feasable treatment for pseudomyxoma peritonei. It is associated with acceptable morbidity when performed by an experienced surgical team. Histologic grade is the major determinant of survival.
引用
收藏
页码:1372 / 1379
页数:8
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