Elevated tumour markers prior to complete tumour removal in patients with pseudomyxoma peritonei predict early recurrence

Objective: To assess the potential value of pre-operative CEA, CA 125 and CA 19-9 in identifying Pseudornyxoma peritonei (PMP) patients at risk of recurrence following complete cytoreductive surgery and intraperitoneal chemotherapy. Method: Between March 1996 and October 2001, 35 patients, with documented pre-operative tumour marker measurements, underwent complete cytoreduction. Outcome in the 32 survivors was recorded. Results: Median age was 53 years (range: 32-74). There were 17[53%] females. In 9/32[28%] all turnout markers were normal. The most common abnormality was elevated CEA level in 14/32[44%]. Median follow up was 23 months (range: 11-74). Recurrence was detected in 8/32[25%]. The 2-year recurrence free interval was 53% in those with elevated CEA compared with 94% with normal CEA. The 2-year disease free intervals were 100% in 9 patients with normal preop markers compared with 66% for the group with at least one abnormal marker. Conclusion: PMP patients with elevated CEA, or more than one abnormal serum turnout maker, are at risk of developing recurrent disease.