Origin Of Pseudomyxoma Peritonei Research Articles

Serum and ascites tumor markers in the diagnostic and prognostic prediction for appendiceal pseudomyxoma peritonei

BackgroundTo investigate the expression of carcinoembryonic antigen (CEA), cancer antigen 199 (CA199) and CA125 in serum and ascites of appendiceal pseudomyxoma peritonei (PMP) patients relative to their diagnostic and predictive value.MethodsThe study comprised 183 patients with pathologically confirmed appendiceal PMP, enrolled from May 2012 to June 2020, in Aerospace Center Hospital. Serum and ascites tumor markers were obtained, and their diagnostic values were compared by receiver operating characteristic (ROC) curves. The prognostic factors of appendiceal PMP with different pathologic subgroups were calculated by univariate and multivariate Cox proportional hazard regression models.ResultsThere were significant differences between the numbers of patients with positive CEA and CA199 in serum vs. ascites: p = 0.034 in CEA and p = 0.006 in CA199, respectively. The sensitivities with optimal cut-off values for ascites markers of CEA, CA199 and CA125 were 83.5%, 88.9% and 72.6%, respectively. CEA in ascites showed significant difference in the diagnosis of appendiceal PMP (p = 0.000); the areas under the ROC curves (AUROCs) and specificity were 0.725, 70.7%, respectively. Univariate analysis showed that the higher the ascites tumor markers, the poorer the survival (p = 0.014). Multivariate analysis indicated that completeness of cytoreduction (CCR), ascites CEA and pathological grade were independent risk factors for overall survival (OS).ConclusionCEA in ascites can be used to help specify the origin of PMP. Furthermore, elevation of ascites CEA, high pathological grade and incomplete cytoreduction predicted poor prognosis of appendiceal PMP.

Pseudomyxoma peritonei (PMP) and its therapy - 20 years experience of a single surgical department.

Pseudomyxoma peritonei (PMP) is arare malignant disease with various grades of malignancy, producing mucinous and gelatinous masses. The origin of PMP is usually connected with the rupture of appendiceal mucinous tumours, other mucinous tumours of the gastrointestinal tract or of the ovary. The staging of this disease is determined by the PCI score (peritoneal cancer index), and the efficiency of surgical procedure by the CC score. Clinical presentation is very variable and depends on the stage of the disease. Many patients are asymptomatic with aminimal clinical finding, presented only with abdominal discomfort. Atypical finding of the “jelly belly“ syndrome expands with progression of the disease. The diagnosis consists in preoperative determination of the tumour characteristics and PCI based on imaging methods, especially CT imaging. The Sugarbaker technique of complete tumour removal or the so-called cytoreductive surgery (CRS) was used, including hyperthermic intraperitoneal chemotherapy (HIPEC) or alternatively early postoperative intraperitoneal chemotherapy (EPIC). We performed retrospective evalu-ation of 73 patients with pseudomyxoma peritonei undergoing surgery, 39 males and 34 females, mean age 50.6 and 56.4 years, respectively. Surgical revision was performed in 18 patients, 14 males and 4 females. The mean age of this group was 48.8 for the males and 47 for the females. The surgical procedures were performed between 1999 and 2018. Survival rates, median survival, complications based on Clavien-Dindo classification, lethality rates, and PCI and CC scores were assessed in the patient group. 96 surgeries were performed in 73 patients with pseudomyxoma peritonei at our surgical department between 19992018. The surgery had to be repeated in 18 patients (24.6%). High grade (HG) pseudomyxoma was diagnosed in 29 patients (39.7%), and low grade (LG) pseudomyxoma in 44 patients (60.3%). Overall morbidity was 27.3%, and the mortality rate was 5.4%. The mean overall survival (OS) was 139.5 months in the LG pseudomyxoma group and 71.5 months in the HG pseudomyxoma group. Median survival was 86 months in the entire group and 72 in the HG pseudomyxoma group; the median was not reached in the LG pseudomyxoma group. Results in the literature and our results are comparable, confirming the high efficiency of this method both in the world and in the Czech republic. The results indicate ahighly statistically significant improvement of the OS with acceptable mortality and morbidity. These results confirm this method as agold standard therapy for selected patients.

Pseudomyxoma peritonei: A Review

Pseudomyxoma peritonei (PMP) is rare clinical entity characterized by abundant extracellular mucinous material in the peritoneal cavity and tumoural implants on the peritoneal surfaces. The origin of PMP is controversial. It often arises from the goblet cells of large bowel or appendix. There is increase in MUC-2 secreting cells and accumulation of excessive mucin secreted by these cells in the peritoneal cavity. A ruptured appendiceal mucinous adenoma is the most common origin. Low grade ovarian malignancy is often associated. Patient may present with growing abdominal masses associated with abdominal pain, nausea, vomiting, fatigue and weight loss. Ultrasonogram and CT scan of the abdomen have role in diagnosis but diagnosis is often difficult before laparotomy or laparoscopy. Debulking surgery with intraperitoneal hyperthermic chemotherapy is the treatment. DOI: http://dx.doi.org/10.3329/fmcj.v7i2.13523 Faridpur Med. Coll. J. 2012;7(2):88-92

A case of pseudomyxoma peritonei associated with borderline mucinous tumor of ovary with invasive metastasis of bladder

Pseudomyxoma peritonei (PMP) is an uncommon entity characterized by large amount of mucinous-jelatinous fluid disseminated in abdominal cavity and pelvic cavity with implants on omentum and bowel. The symptoms of this disease are mostly abdominal distension, dyspepsia, and intraabdominal palpable mass. The origin of PMP is under investigation yet, that is known to arise from appendix, ovary mostly. Also it’s etiology, treatment, and prognosis are speculative. Rare cases were reported that have invasion to other organ except appendix and ovaries, but we experienced a case of PMP associated with borderline mucinous tumor of ovary with invasive metastasis of bladder. So we report this case with a brief review with literature.