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Pseudomyxoma Peritonei — SCE Medical Oncology MCQ

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HardGI CancersPseudomyxoma PeritoneiSCE Medical Oncology

A 58-year-old woman with advanced appendiceal mucinous adenocarcinoma and pseudomyxoma peritonei is referred to a specialist centre. She has extensive peritoneal disease but no extra-abdominal metastases. What is the potentially curative treatment approach?

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Correct answer: B — Cytoreductive surgery (CRS) + heated intraperitoneal chemotherapy (HIPEC)

Pseudomyxoma peritonei (PMP) from appendiceal mucinous neoplasms is managed with cytoreductive surgery (peritonectomy) combined with HIPEC (typically mitomycin C). This approach, pioneered by Sugarbaker, achieves 10-year survival rates of approximately 60-70% in selected patients with low-grade appendiceal PMP. Complete cytoreduction (CCR-0/1) is the strongest prognostic factor. This should be performed in specialist peritoneal malignancy centres (NICE commissioning guidelines).

Reference: NICE Specialist Commissioning — Peritoneal Malignancy; ESMO 2024 Peritoneal Surface Malignancy Guidelines; Sugarbaker et al Ann Surg 2006