Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy to treat pseudomyxoma peritonei of ovarian origin: A retrospective French RENAPE group study
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Trecourt, Alexis | Bakrin, Naoual | Glehen, Olivier | Gertych, Witold | Villeneuve, Laurent | Isaac, Sylvie | Benzerdjeb, Nazim | Fontaine, Juliette | Genestie, Catherine | Dartigues, Peggy | Leroux, Agnès | Quenet, François | Marchal, Frederic | Odin, Cecile | Khellaf, Lakhdar | Svrcek, Magali | Thierry, Sixte | Augros, Marilyn | Omar, Alhadeedi | Devouassoux-Shisheboran, Mojgan | Kepenekian, Vahan | Abba, Julio | Abboud, Karine | Aimé, Adeline | Amroun, Koceila | André, Thierry | Arvieux, Catherine | Averous-Lang, Gerlinde | Bardier, Armelle | Rejeb, Houda Ben | Bereder, Jean-Marc | Bertheau, Philippe | Bibeau, Frédéric | Boige, Valérie | Bonnot, Pierre-Emmanuel | Bouché, Olivier | Bouhidel, Fatiha | Bouzard, Marie-Dominique | Brigand, Cécile | Broudin, Chloé | Celerier, Bertrand | Ceribelli, Cécilia | Charissoux, Aurélie | Chevallier, Anne | Clément, Elise | Coget, Julien | Courvoisier-Clément, Thomas | Dazza, Marie | de Chaisemartin, Cécile | Di Fiore, Frédéric | Dumont, Frédéric | Durand-Fontanier, Sylvaine | Eveno, Clarisse | Ezanno, Anne-Cécile | Facy, Olivier | Ferron, Gwenaël | Gagnière, Johann | Galan, Alexandre | Gelli, Maximiliano | Ghouti, Laurent | Gladieff, Laurence | Goere, Diane | Guilloit, Jean-Marc | Guyon, Frédéric | Heyd, Bruno | Heymann, Marie-Françoise | Hübner, Martin | Illac-Vauquelin, Claire | Kaci, Rachid | Kefleysus, Amaniel | Kianmanesh, Reza | Laverrière, Marie-Hélène | Lebrun-Ly, Valérie | Lefevre, Jérémie | Lelong, Bernard | Lemaistre, Anne-Isabelle | Malgras, Brice | Mariani, Pascale | Mariani, Antoine | Meeus, Pierre | Mery, Eliane | Narducci, Fabrice | Nougaret, Stéphanie | Orry, David | Ortega-Deballon, Pablo | Paquette, Brice | Péron, Julien | Peyrat, Patrice | Pezet, Denis | Pirro, Nicolas | Pocard, Marc | Poizat, Flora | Raimbourg, Judith | Rat, Patrick | Ries, Pauline | Rousset, Pascal | Sage, Pierre-Yves | Senellart, Hélène | Sgarbura, Olivia | Smolenschi, Cristina | Sourrouille, Isabelle | Taibi, Abdelkader | Tessier, Williams | Thibaudeau, Emilie | Touchefeu, Yann | Trilling, Bertrand | Tuech, Jean-Jacques | Valmary-Degano, Séverine | Varatharajah, Sharmini | Verriele-Beurrier, Véronique | Vogin, Guillaume | Wernert, Romuald | You, Benoit
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Background: Ovarian pseudomyxoma peritonei (OPMP) are rare, without well-defined therapeutic guidelines. We aimed to evaluate cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) to treat OPMP.Methods: Patients from the French National Network for Rare Peritoneal Tumors (RENAPE) database with proven OPMP treated by CRS/HIPEC and with histologically normal appendix and digestive endoscopy were retrospectively included. Clinical and follow-up data were collected. Histopathological and immunohistochemical features were reviewed.Results: Fifteen patients with a median age of 56 years were included. The median Peritoneal Cancer Index was 16. Following CRS, the completeness of cytoreduction (CC) score was CC-0 for 9/15 (60%) patients, CC-1 for 5/15 (33.3%) patients, and CC-2 for 1/15 (6.7%) patients. The median tumor size was 22.5 cm. After pathological review and immunohistochemical studies, tumors were classified as Group 1 (mucinous ovarian epithelial neoplasms) in 3/15 (20%) patients; Group 2 (mucinous neoplasm in ovarian teratoma) in 4/15 (26.7%) patients; Group 3 (mucinous neoplasm probably arising in ovarian teratoma) in 5/15 (33.3%) patients; and Group 4 (non-specific group) in 3/15 (20%) patients. Peritoneal lesions were OPMP pM1a/acellular, pM1b/grade 1 (hypocellular) and pM1b/grade 3 (signet-ring cells) in 13/15 (86.7%), 1/15 (6.7%) and 1/15 (6.7%) patients, respectively. Disease-free survival analysis showed a difference (p = 0.0463) between OPMP with teratoma/likely-teratoma origin (groups 2 and 3; 100% at 1, 5, and 10 years), and other groups (groups 1 and 4; 100%, 66.6%, and 50% at 1, 5, and 10 years, respectively).Conclusion: These results suggested that a primary therapeutic strategy using complete CRS/HIPEC for patients with OPMP led to favorable long-term outcomes.