Abstract:
Objective To investigate the clinicopathological features and treatment strategy of pseudomyxoma peritonei (PMP) of extra-appendiceal origin.
Methods Clinical data of 34 patients diagnosed with PMP of extra-appendiceal origin who were treated by cytoreduction 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 abdominal 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 index (PCI) >20, no HIPEC, and non-radical surgery were significant risk factors for poor prognosis, while gender, age, origin, and pathological type did not show significant correlations.
Conclusions The clinical features of PMP of extra-appendiceal origin are not different to those of PMP originating from the appendix. It is difficult to ascertain the primary lesion before the operation; however, regardless of the origin, CRS combined with HIPEC is always a safe and effective treatment choice.