Approach to pseudomyxoma peritonei

Table 1 Classification of pseudomyxoma peritonei

System	Classification
Ronnett et al[8]	DPAM: PMP with mucinous ascites on the surface of peritoneum. No invasion. Indolent course. Best prognosis PMCA: Higher percentage of malignant cells. Poorer prognosis PMCA-I: Intermediate hybrid between DPAM and PMCA
WHO	Low grade: Mucin pools with low grade dysplasia. Eighty-three percent of five-year OS High Grade: Mucin pools with high grade dysplasia. More likely for rupture and spillage into the peritoneal cavity. Sixty-eight percent of five-year OS

PMP: Pseudomyxoma peritonei; DPAM: Diffuse peritoneal adenomucinous; PMCA: Peritoneal mucinous carcinomatosis; PMCA-I: Peritoneal mucinous carcinamatosis-intermediate; OS: Overall survival; WHO: World Health Organization.

Table 2 Cytoreductive score

Score	Tumor burden
CC0	No residual tumor
CC1	Residual tumor < 2.5 mm
CC2	Residual tumor between 2.6 mm and 2.5 cm
CC3	Residual tumor > 2.5 cm

Table 3 Five-year overall survival

Ref.	Year	Type of study	No. of patients	Five-year OS (%)
Baratti et al[27]	2018	Retrospective	265	74.5
Pallas et al[28]	2017	Retrospective	100	43
Chia et al[29]	2016	Systematic Review	NA	13-23
Moran et al[30]	2015	Retrospective	956	84
Gupta et al[10]	2014	Retrospective	791	68-83
Chua et al[31]	2012	Retrospective	2020	82
Smeenk et al[20]	2007	Retrospective	103	59.5

NA: Not available; OS: Overall survival.

Table 4 Complications of complete cytoreductive surgery/hyperthermic intraperitoneal chemotherapy

Ref.	Year	Type of study	No. of patients	Complication(s)
Hamilton et al[32]	2016	Retrospective	42	Intrabdominal abscess: 9.5%
				Bleeding: 9.1%
				Pleural effusion: 7.1%
				Anastomotic leak: 7.1%
				Renal failure: 2.4%
Chua et al[18]	2012	Retrospective	2020	Post-op mortality 2%
				Major complications grade III/IV: 24%
				Recurrence: 19%
Chua et al[31]	2009	Systematic Review	NA	Hematological toxicity: 28%
				Reoperation rates: 23%
				Sepsis: 14%
				Fistula: 23%
				Abscess: 37%
				Ileus: 86%
				Perforation: 10%
				Anastomotic leak: 9%
				DVT/PE: 9%
				Renal insufficiency: 7%

NA: Not available; DVT/PE: Deep vein thrombosis/pulmonary embolism.