Identifying Prognostic Factors in Japanese Women with Pseudomyxoma Peritonei: A Retrospective Clinico-Pathological Study of the Tohoku Gynecologic Cancer Unit
Identifying Prognostic Factors in Japanese Women with Pseudomyxoma Peritonei: A Retrospective Clinico-Pathological Study of the Tohoku Gynecologic Cancer Unit
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DOI：
10.1620/tjem.223.91
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发表时间：
2011-02-01
影响因子：
2.2
通讯作者：
Kurachi, Hirohisa
中科院分区：
文献类型：
--
作者：
Kojimahara, Takanobu;Nakahara, Kenji;Kurachi, Hirohisa
腹膜假性粘液瘤是一种罕见的粘液性腹水，主要与阑尾或卵巢的粘液性肿瘤相关。PMP经常在治疗后复发，并可能最终通过压迫粘液性腹水导致腹部内脏功能障碍而死亡。尽管根治性腹膜切除术和温热腹膜内化疗正在全球流行，但日本尚未确定PMP的最佳治疗方法。我们进行了一项多中心的回顾性研究，以阐明PMP的最佳治疗方法和预后因素。对东北地区妇科癌症中心(TGCU)的23名PMP患者进行了分析。检索临床和随访数据，并进行中心病理学回顾。中位随访期46个月。11例完全切除。在此期间，13例复发/进展中有7例死亡。所有复发/进展均局限于腹部。出乎意料的是，既没有进行根治性腹膜切除术，也没有进行温热腹膜内化疗，这表明根治性腹膜切除术和温热腹膜内化疗在日本还不流行。中位生存期为166个月，中位无病期为30个月。单因素和多因素分析显示，大体残留肿瘤是影响预后的唯一因素(P=0.022)。虽然化疗不是影响预后的因素(P=0.064)，但接受腹膜腔内化疗的患者预后往往好于全身化疗或未接受化疗的患者(P=0.05)。总而言之，肉眼可见的残留肿瘤是影响日本PMP患者预后的重要因素。
Pseudomyxoma peritonei (PMP) is a rare condition of mucinous ascites associated mainly with mucinous tumors of appendix or ovary. PMP often recurs after treatment and may eventually cause death by abdominal visceral dysfunction via compression with mucinous ascites. Although radical peritonectomy and hyperthermic intra-peritoneal chemotherapy are becoming popular globally, the optimal treatment of PMP has not been established in Japan. We conducted a retrospective multicenter study to clarify the optimal treatment and the prognostic factors of PMP. A total of 23 patients with PMP were analyzed in the Tohoku Gynecologic Cancer Unit (TGCU). Clinical and follow-up data were retrieved and a central pathology review was performed. The median follow-up period was 46 months. Eleven patients underwent complete resection. There were 7 deaths out of 13 recurrences/progressions in this period. All the recurrence/progression was confined to the abdomen. Unexpectedly, neither radical peritonectomy nor hyperthermic intra-peritoneal chemotherapy had been performed, indicating that both radical peritonectomy and hyperthermic intra-peritoneal chemotherapy are not yet popular in Japan. The medians of overall survival and disease-free period were 166 months and 30 months, respectively. Univariate and multivariate analyses revealed that the only prognostic factor was macroscopic residual tumor (P = 0.022). Although chemotherapy was not a prognostic factor (P = 0.16), those who received intra-peritoneal chemotherapy tended to have a better prognosis than those who received systemic or no chemotherapy (P = 0.064). In conclusion, the macroscopic residual tumor is an important prognostic factor in Japanese patients with PMP.