New Insights in the Management of Pseudomyxoma Peritonei

Overview

Journal J Surg Oncol

Specialties General Surgery
Oncology

Date 2024 Aug 29

PMID 39206531

Authors

Clement Pastier

I H J T de Hingh

Diane Goere

Affiliations

Soon will be listed here.

Abstract

While a rare entity, peritoneal pseudomyxoma treatment evolves. Decision-making criteria improve with imaging development and exploratory laparoscopy. Surgery remains at the core of the therapeutic strategy whatever disease progression. Complete cytoreduction plus hyperthermic intraperitoneal chemotherapy (HIPEC) is standard of care. Iterative cytoreduction or debulking is sometimes justified. Intraperitoneal chemotherapy modalities change with early postoperative HIPEC or pressurized intraperitoneal aerosol chemotherapy. Systemic or local treatment such as new chemo/immuno-therapies or BromAc should improve outcomes. Expertise and multicentric cooperation are more than ever needed.

Citing Articles

New insights in the management of pseudomyxoma peritonei.

Pastier C, de Hingh I, Goere D J Surg Oncol. 2024; 130(6):1316-1325.

PMID: 39206531 PMC: 11826005. DOI: 10.1002/jso.27842.

References

Fichtinger R, Aldrighetti L, Abu Hilal M, Troisi R, Sutcliffe R, Besselink M . Laparoscopic Versus Open Hemihepatectomy: The ORANGE II PLUS Multicenter Randomized Controlled Trial. J Clin Oncol. 2024; 42(15):1799-1809. PMC: 11107897. DOI: 10.1200/JCO.23.01019. View

Pawar A, Warikoo V, Salunke A, Sharma M, Pandya S, Bhardwaj A . Outcomes of minimal access cytoreductive surgery (M-CRS) and HIPEC/EPIC vs. open cytoreductive surgery (O-CRS) and HIPEC/EPIC in patients with peritoneal surface malignancies: a meta-analysis. Pleura Peritoneum. 2024; 9(1):1-13. PMC: 10980983. DOI: 10.1515/pp-2023-0017. View

Choudry H, Mavanur A, OMalley M, Zeh H, Guo Z, Bartlett D . Chronic anti-inflammatory drug therapy inhibits gel-forming mucin production in a murine xenograft model of human pseudomyxoma peritonei. Ann Surg Oncol. 2012; 19(5):1402-9. PMC: 4125010. DOI: 10.1245/s10434-012-2242-5. View

Nagtegaal I, Odze R, Klimstra D, Paradis V, Rugge M, Schirmacher P . The 2019 WHO classification of tumours of the digestive system. Histopathology. 2019; 76(2):182-188. PMC: 7003895. DOI: 10.1111/his.13975. View

Strach M, Chakrabarty B, Nagaraju R, Mullamitha S, Braun M, ODwyer S . Defining a role for systemic chemotherapy in local and advanced appendix adenocarcinoma. ESMO Open. 2023; 8(5):101619. PMC: 10619141. DOI: 10.1016/j.esmoop.2023.101619. View

Bhatt A, Glehen O . Extent of Peritoneal Resection for Peritoneal Metastases: Looking Beyond a Complete Cytoreduction. Ann Surg Oncol. 2020; 27(5):1458-1470. DOI: 10.1245/s10434-020-08208-z. View

Dineen S, Royal R, Hughes M, Sagebiel T, Bhosale P, Overman M . A Simplified Preoperative Assessment Predicts Complete Cytoreduction and Outcomes in Patients with Low-Grade Mucinous Adenocarcinoma of the Appendix. Ann Surg Oncol. 2015; 22(11):3640-6. PMC: 4565864. DOI: 10.1245/s10434-015-4446-y. View

Yang J, Glenn D, Lodh S, Valle S, Morris D . Long-Term Treatment of Unresectable Pseudomyxoma Peritonei with Multiple Treatments of Intratumoural Bromelain and Acetylcysteine (BromAc): A Case Report. Case Rep Oncol. 2023; 16(1):1551-1556. PMC: 10708900. DOI: 10.1159/000534202. View

Pillai K, Akhter J, Chua T, Morris D . A formulation for in situ lysis of mucin secreted in pseudomyxoma peritonei. Int J Cancer. 2013; 134(2):478-86. DOI: 10.1002/ijc.28380. View

10.

Logan-Collins J, Lowy A, Robinson-Smith T, Kumar S, Sussman J, James L . VEGF expression predicts survival in patients with peritoneal surface metastases from mucinous adenocarcinoma of the appendix and colon. Ann Surg Oncol. 2007; 15(3):738-44. DOI: 10.1245/s10434-007-9699-7. View

11.

Grass F, Vuagniaux A, Teixeira-Farinha H, Lehmann K, Demartines N, Hubner M . Systematic review of pressurized intraperitoneal aerosol chemotherapy for the treatment of advanced peritoneal carcinomatosis. Br J Surg. 2017; 104(6):669-678. DOI: 10.1002/bjs.10521. View

12.

Corfield A, Myerscough N, Longman R, Sylvester P, Arul S, Pignatelli M . Mucins and mucosal protection in the gastrointestinal tract: new prospects for mucins in the pathology of gastrointestinal disease. Gut. 2000; 47(4):589-94. PMC: 1728059. DOI: 10.1136/gut.47.4.589. View

13.

Alyami M, Mercier F, Siebert M, Bonnot P, Laplace N, Villeneuve L . Unresectable peritoneal metastasis treated by pressurized intraperitoneal aerosol chemotherapy (PIPAC) leading to cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Eur J Surg Oncol. 2019; 47(1):128-133. DOI: 10.1016/j.ejso.2019.06.028. View

14.

Esquivel J, Averbach A, Chua T . Laparoscopic cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in patients with limited peritoneal surface malignancies: feasibility, morbidity and outcome in an early experience. Ann Surg. 2011; 253(4):764-8. DOI: 10.1097/SLA.0b013e31820784df. View

15.

Passot G, Dumont F, Goere D, Arvieux C, Rousset P, Regimbeau J . Multicentre study of laparoscopic or open assessment of the peritoneal cancer index (BIG-RENAPE). Br J Surg. 2018; 105(6):663-667. DOI: 10.1002/bjs.10723. View

16.

Merrell D, McAvoy T, King M, Sittig M, Millar E, Nieroda C . Pre- and post-operative antibiotics in conjunction with cytoreductive surgery and heated intraperitoneal chemotherapy (HIPEC) should be considered for pseudomyxoma peritonei (PMP) treatment. Eur J Surg Oncol. 2019; 45(9):1723-1726. DOI: 10.1016/j.ejso.2019.01.223. View

17.

Kusamura S, Moran B, Sugarbaker P, Levine E, Elias D, Baratti D . Multicentre study of the learning curve and surgical performance of cytoreductive surgery with intraperitoneal chemotherapy for pseudomyxoma peritonei. Br J Surg. 2014; 101(13):1758-65. DOI: 10.1002/bjs.9674. View

18.

Arjona-Sanchez A, Aziz O, Passot G, Salti G, Esquivel J, Van der Speeten K . Laparoscopic cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for limited peritoneal metastasis. The PSOGI international collaborative registry. Eur J Surg Oncol. 2020; 47(6):1420-1426. DOI: 10.1016/j.ejso.2020.11.140. View

19.

Moran B, Cecil T . The etiology, clinical presentation, and management of pseudomyxoma peritonei. Surg Oncol Clin N Am. 2003; 12(3):585-603. DOI: 10.1016/s1055-3207(03)00026-7. View

20.

Low R, Barone R, Lucero J . Comparison of MRI and CT for predicting the Peritoneal Cancer Index (PCI) preoperatively in patients being considered for cytoreductive surgical procedures. Ann Surg Oncol. 2014; 22(5):1708-15. DOI: 10.1245/s10434-014-4041-7. View