BACKGROUND Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) provide long-term survival for low-grade pseudomyxoma peritonei (PMP) and multicystic peritoneal mesothelioma (MM). Feasibility of laparoscopic CRS-HIPEC has been reported for selected patients but data regarding long-term outcomes are missing to assess the oncological interest. This study aimed to report long-term outcomes for low-grade PMP and MM treated by laparoscopic approach. METHODS From a prospectively maintained CRS-HIPEC database, all patients who underwent laparoscopic CRS-HIPEC with curative intent were analyzed. Selection criteria for laparoscopic approach were low-grade PMP or MM, with pathological confirmation prior to CRS-HIPEC, ASA 2, age < 75 years, no extrap-eritoneal disease, Peritoneal Cancer Index (PCI) < 10, and a limited history of abdominal surgery. RESULTS Between March 2009 and June 2017, 43 patients were scheduled for laparoscopic CRS and HIPEC. Laparoscopic CRS and HIPEC was completed (LSC) in 32 patients and 11 patients were converted to open surgery (CONV). Median age was 44.5 years (17.13-71.4) in the LSC group and 54.9 years (22.5-70.5) in the CONV group (p = 0.086). Median BMI was not different between groups, 21.2 and 23.9 for LSC and CONV groups, respectively (p = 0.267). There were 21 and 11 patients in the LSC group, and 8 and 3 in the CONV group, with PMP and MM, respectively (p = 0.794). Median PCI was 2.5 (0-9) and 7 (1-15) in the LSC and CONV groups, respectively (p = 0.004). There was no difference in the completeness of cytoreduction score (p = 0.256). After a median follow-up of 31.6 months (95% CI 19.3-36.4), 2 patients in the LSC group and 2 patients in the CONV group presented with peritoneal recurrence. CONCLUSION For selected patients with low aggressive peritoneal disease, laparoscopic CRS-HIPEC provides interesting long-term outcomes.

中文翻译：

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腹腔镜细胞减灭术和HIPEC用于治疗低度假性粘液性腹膜癌和多囊性间皮瘤的长期结果。

背景技术细胞减灭术（CRS）和腹膜高温化疗（HIPEC）为低度假性粘液性腹膜癌（PMP）和多囊性腹膜间皮瘤（MM）提供长期生存。已经报道了对于某些患者的腹腔镜CRS-HIPEC的可行性，但是缺少有关长期结局的数据来评估肿瘤学的兴趣。这项研究旨在报告通过腹腔镜方法治疗的低级PMP和MM的长期结果。方法从前瞻性维护的CRS-HIPEC数据库中，分析所有接受根治性手术的腹腔镜CRS-HIPEC患者。腹腔镜手术的选择标准为低级PMP或MM，在CRS-HIPEC之前已得到病理确诊，ASA 2，年龄<75岁，无腹膜外疾病，腹膜癌指数（PCI）<10，并且腹部手术史有限。结果2009年3月至2017年6月，计划对43例患者进行腹腔镜CRS和HIPEC。腹腔镜CRS和HIPEC完成（LSC）的32例患者和11例患者转为开放手术（CONV）。LSC组的中位年龄为44.5岁（17.13-71.4），CONV组的中位年龄为54.9岁（22.5-70.5）（p = 0.086）。各组之间的BMI中位数无差异，LSC和CONV组分别为21.2和23.9（p = 0.267）。LSC组有21例和11例，CONV组有8例和3例，分别为PMP和MM（p = 0.794）。LSC和CONV组的中位PCI分别为2.5（0-9）和7（1-15）（p = 0.004）。细胞减少分数的完整性无差异（p = 0.256）。经过31.6个月的中位随访（95％CI 19.3-36.4），LSC组2例，CONV组2例出现腹膜复发。结论对于低侵略性腹膜疾病的特定患者，腹腔镜CRS-HIPEC可提供有趣的长期结果。