Li WW, Ru XM, Xuan HY, Fan Q, Zhang JJ, Lu J. Analysis of therapeutic effect of cell reduction combined with intraperitoneal thermoperfusion chemotherapy in treatment of peritoneal pseudomyxoma. World J Gastrointest Surg 2024; 16(11): 3520-3530 [DOI: 10.4240/wjgs.v16.i11.3520]
Corresponding Author of This Article
Jun Lu, Doctor, Department of Endocrinology, The Second Affiliated Hospital of Soochow University, No. 1055 Sanxiang Road, Suzhou 215004, Jiangsu Province, China. lujun.198404@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
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World J Gastrointest Surg. Nov 27, 2024; 16(11): 3520-3530 Published online Nov 27, 2024. doi: 10.4240/wjgs.v16.i11.3520
Table 1 Status of 186 cases of pseudomyxoma of abdominal cavity treated by cell reduction combined with intraperitoneal hyperthermic chemotherapy, n (%)
Variable
Number of cases
Primary site
Appendix
170 (91.4)
Ovary
15 (8.1)
Location
1 (0.5)
Pathological type
Low-level
99 (53.2)
High level
57 (30.6)
Not quite clear
30 (16.1)
Lymph node metastasis
Correct
19 (10.2)
Deny
151 (81.2)
Suspicious transfer
16 (8.6)
Meningeal tumor index score
≤ 10
7 (3.8)
11-20
34 (18.3)
21-30
56 (30.1)
31-39
55 (29.6)
Not quite clear
34 (18.3)
CCR rating
CCR-0
15 (8.1)
CCR-1
40 (21.5)
CCR-2/3
113 (60.8)
Not quite clear
18 (9.7)
Whether to combine organ resection
Correct
123 (66.1)
Deny
63 (33.9)
HIPEC count
1
30 (16.1)
2
48 (25.8)
3
79 (42.5)
4
25 (13.4)
5
4 (2.2)
HIPEC drugs
Raltitrexed
47 (25.3)
Letotrexate + Oxaliplatin + Mitomycin
42 (22.6)
Platinum
32 (17.2)
Letotrexate + Oxaliplatin
25 (13.4)
Letotrexate + Mitomycin
20 (10.8)
Mitomycin
8 (4.3)
Oxaliplatin + Mitomycin
8 (4.3)
Other
4 (2.2)
Table 2 186 patients with pseudomyxoma were treated with cell reduction combined with intraperitoneal hyperthermic chemotherapy
Incidence of complications
n (%)
Death 30 days after surgery
5 (2.7)
Death 90 days after surgery
8 (4.3)
Further surgery is required
3 (1.6)
Grade III-IN complications
80 (43.0)
Gastrointestinal anastomotic leakage
4 (2.2)
Urinary system complications (ureteral injury, urinary leakage, etc.)
1 (0.5)
Abdominal bleeding
4 (2.2)
Abdominal infection
8 (4.3)
Wound infection
2 (1.1)
Sepsis or sepsis
1 (0.5)
Urinary tract infection
1 (0.5)
Ascites
4 (2.2)
Pneumonia
10 (5.4
Pneumothorax
2 (1.1)
Cardiac insufficiency or heart failure
2 (1.1)
Renal insufficiency
1 (0.5)
Hepatic insufficiency
19 (10.2)
Septic shock
2 (1.1)
Hemorrhagic shock
2 (1.1)
Albumin reduction
14 (7.5)
Hemoglobin reduction
51 (27.4)
Thrombocytopenia
2 (1.1)
Electrolyte disturbance
21 (11.6)
Coagulopathy
11 (5.9)
Table 3 Analysis of factors of incidence of grade III to IV complications in pseudomyxoma of abdominal cavity undergoing cell reduction combined with intraperitoneal
Clinical variables
Cases
Grade III-IV complications incidence rate, n (%)
χ2
P value
Age (years)
0.105
0.746
Up to 60
121
51 (42.1)
Greater than 60
65
29 (44.6)
Gender
0.088
0.766
Male
65
27 (41.5)
Female
121
53 (43.8)
Primary site
2.552
0.225
Appendix
170
71 (41.8)
Ovary
15
9 (9/15)
Other
1
0
Pathological level
0.278
0.598
Low-level
99
46 (46.5)
High level
57
24 (42.1)
Lymph node metastasis
0.349
0.818
Correct
19
8 (8/19)
Deny
151
64 (42.4)
Suspicious transfer
16
8 (8/16)
Peritoneal tumor index score (points)
1.332
0.536
≤ 20
41
16 (39.0)
21-39
111
55 (49.5)
Whether to combine organ resection
14.33
< 0.001
Correct
123
65 (52.8)
Deny
63
15 (23.8)
HIPEC count
4.9
0.298
1
30
17 (56.7)
2
48
16 (33.3)
3
79
34 (43.0)
4
25
12 (48.0)
5
4
1 (1/4)
Table 4 Efficacy of cytopenia combined with Intraperitoneal hyperthermic chemotherapy to observe the survival of patients with peritoneal pseudomyxoma with different clinical features
Variable
Cases
5-year OS (%)
95%CI (%)
P value
Age (years)
0.480
Up to 60
121
48.7
36.9-60.5
Greater than 60
65
54.2
37.9-70.5
Gender
0.139
Male
65
41.8
26.1-57.5
Female
121
55.4
43.6-67.2
Primary site
0.701
Appendix
170
50.6
40.6-60.6
Ovary
15
49.5
16.8-82.2
Other
l
Pathological level
< 0.00
Low-level
99
68.1
54.8-81.4
High level
57
26.3
11.0-41.6
Lymph node metastasis
0.107
Correct
19
54.3
27.8-80.8
Deny
151
49.4
39.2-59.6
Suspicious transfer
16
66.7
13.4-100.0
Peritoneal tumor index score (points)
0.001
0.001
≤ 20
41
82.1
67.4-96.8
21-39
111
44.0
30.5-57.5
CCR score
< 0.001
CCR-0
15
88.9
68.3-100.0
CCR-1
40
77.6
62.7-92.5
CCR-2/3
113
42.0
29.5-54.5
Whether to combine organ resection
0.915
Correct
123
46.3
32.8-59.8
Deny
63
54.7
40.8-68.6
HIPEC treatment plan
0.597
Raltitrexed
47
67.7
51.4~84.0
Oxaliplatin + Letotrexate + Mitomycin
42
50.8
23.8~77.8
Platinum
32
40.2
21.4-59.0
Oxaliplatin + Letotrexate
25
30.0
9.0-51.0
Letotrexate + Mitomycin
20
100
Mitomycin
8
50.0
10.0-90.0
Oxaliplatin + Mitomycin
8
37.5
4.0-71.0
Other
4
50.0
1.0-99.0
Citation: Li WW, Ru XM, Xuan HY, Fan Q, Zhang JJ, Lu J. Analysis of therapeutic effect of cell reduction combined with intraperitoneal thermoperfusion chemotherapy in treatment of peritoneal pseudomyxoma. World J Gastrointest Surg 2024; 16(11): 3520-3530