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International Journal of Colorectal Disease

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01-03-2012 | Original Article

Early recurrence of pseudomyxoma peritonei following treatment failure of cytoreductive surgery and perioperative intraperitoneal chemotherapy is indicative of a poor survival outcome

Authors: Terence C. Chua, Winston Liauw, David L. Morris

Published in: International Journal of Colorectal Disease | Issue 3/2012

Abstract

Background

The aim of this study was to identify predictors of early recurrence to optimize outcomes.

Methods

A comparison of clinicopathological factors between patients who developed early recurrence (≤12 months) and late recurrence (>12 months) was performed to identify predictors of treatment failure through univariate and multivariate analyses. Survival parameters were estimated using the Kaplan–Meier method.

Results

A total of 113 patients with a median PCI of 24 (range, 2–39) underwent cytoreductive surgery. The median progression-free and overall survival was 48 and 104 months, respectively. Multivariate analysis identified prior operations >1, ≥10 units of fresh frozen plasma (FFP) transfusion, incomplete cytoreduction and not undergoing definitive cytoreductive surgery within 12 months of diagnosis as predictors for disease recurrence. Twenty of 41 patients (49%) developed early recurrence. The median overall survival of patients who developed early recurrence was 38 months and in patients who did not develop early recurrence was 97 months (P = 0.002). Subgroup analysis of patients with recurrence identified the male gender (P = 0.028), elevated CA 125 (P = 0.037), having elevated carcinoembryonic antigen (CEA), CA 125 and CA 19-9 (P = 0.029), peritoneal cancer index >25 (P = 0.020), incomplete cytoreduction (P = 0.020), >6 units of blood transfusion (P = 0.020) and >10 units of FFP transfusion (P = 0.009) as factors associated with early recurrence.

Conclusion

Early recurrence of pseudomyxoma peritonei occurs despite achieving high rates of oncologically optimal cytoreduction. The clinicopathologic factors associated with early recurrence identified in this study may inform us about patients at greatest risk of treatment failure during the post cytoreduction follow-up.

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Title: Early recurrence of pseudomyxoma peritonei following treatment failure of cytoreductive surgery and perioperative intraperitoneal chemotherapy is indicative of a poor survival outcome
Authors: Terence C. Chua
Winston Liauw
David L. Morris
Publication date: 01-03-2012
Publisher: Springer-Verlag
Published in: International Journal of Colorectal Disease / Issue 3/2012
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-011-1303-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Early recurrence of pseudomyxoma peritonei following treatment failure of cytoreductive surgery and perioperative intraperitoneal chemotherapy is indicative of a poor survival outcome

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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