The Assessment of Malignant Potential according to Peritoneal Carcinomatosis Index of Pseudomyxoma Peritonei

Goro Tsukiyama, Yutaka Yonemura, Taiichi Kawamura, Etsuro Bandoh, Hiroaki Itoh, Kimihide Kusafuka* and PH Sugarbaker**

Department of Gastric Surgery and Peritoneal Dissemination and Department of Pathological Diagnosis*, Shizuoka Cancer Center
Washington Hospital Center**

In the present study, 15 patients with pseudomyxoma peritonei (PMP) were treated and correlation between Peritoneal Carcinomatosis Index (PCI) and degree of malignancy were studied for the introduction of PCI as a tool to select the treatments for PMP. PCI is the indicator of distribution and amount of peritoneal dissemination. In 15 patients, male:female ratio is 2:1, the mean age is 57. To make pathological diagnosis, HE stain, mucin stain and immunohistochemical stain were done. For all patients, results of mucicarmin stain, MUC2 stain and MUC5AC stain were positive. So diagnosis was confirmed as PMP. In these 15 patients, one and 12 cases originated from ovary and appendix respectively. According to the Ronnet's histological classification, 8, 6 and 1 were diagnosed as peritoneal mucinous carcinomatosis (PMCA), PMCA intermediate malignancy, and disseminating peritoneal adenomucinosis respectively. Complete cytoreduction was done in 2 patients and PCIs of those were 9 and 10. On the other hand, PCIs of 13 patients who had received incomplete cytoreduction ranged from 22 to 35 (mean 29.5). Two patients who had received complete cytoreduction are still alive without recurrence. PCI is a useful indicator of malignancy for PMP. It is very important to calculate PCI before attempt the surgical therapy in PMP.

Key words
pseudomyxoma peritonei, immunohistochemical stain, peritoneal carcinomatosis index

Reprint requests
Goro Tsukiyama Department of Gastric Surgery and Peritoneal Dissemination, Shizuoka Cancer Center
1007 Shimonagakubo, Nagaizumi-Cho, Suntou-Gun, 411-8777 JAPAN

Accepted
March 28, 2007

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