Primary peritonectomy/HIPEC for disseminated peritoneal adenomucinosis achieves much lower recurrence rates and better survival than secondary procedures

Surgeon. 2009 Dec;7(6):345-50. doi: 10.1016/s1479-666x(09)80108-x.

Abstract

Background: Two main treatment options are available for pseudomyxoma peritonei (PMP) and disseminated peritoneal adenomucinosis (DPAM)--incomplete cytoreductive (debulking) surgery and peritonectomy with intraperitoneal chemotherapy. Several studies have demonstrated improved survival with peritonectomy. This study analyses outcome following peritonectomy in patients undergoing a primary procedure compared to those who have had previous debulks.

Methods: Between April 1997 and May 2008, 63 patients underwent peritonectomy for DPAM--38 had had previous debulk(s) and 25 underwent primary peritonectomy. Patients were followed-up at three- to six-monthly intervals postoperatively, with a mean follow-up time of 21 and 34 months, respectively.

Results: Mean survival for patients undergoing primary peritonectomy was 109.8 months. Mean survival for patients with previous debulks was 49.2 months (p=0.027). Five-year survival was 95.5% in the primary peritonectomy group and 67.5% in the previous debulk group.

Conclusion: Disease recurrence after primary peritonectomy for DPAM is significantly less frequent than after secondary peritonectomy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Digestive System Surgical Procedures / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Peritoneal Cavity / surgery
  • Peritoneal Neoplasms / drug therapy
  • Peritoneal Neoplasms / mortality
  • Peritoneal Neoplasms / pathology
  • Peritoneal Neoplasms / surgery*
  • Pseudomyxoma Peritonei / drug therapy
  • Pseudomyxoma Peritonei / mortality
  • Pseudomyxoma Peritonei / pathology
  • Pseudomyxoma Peritonei / surgery*
  • Young Adult