ABSTRACT
This chapter describes the various management strategies for recurrent pseudomyxoma peritonei (PMP). A large study from a high-volume United Kingdom centre of 512 patients described a recurrence rate following complete cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) of 26.4% during the follow-up period of 39 months. A retrospective study from PMI Basingstoke demonstrated the following risk factors for recurrence after complete CRS and HIPEC. Treatment options for recurrent PMP include an active watch-and-wait approach, systemic chemotherapy, surgery and palliation. Some variation between the different units with regard to the approach to follow-up and a universally adopted surveillance protocol after CRS and HIPEC has not been established. The patient underwent re-do surgery where a complete cytoreduction was achieved by performing a total gastrectomy. Strategies to reduce recurrence are best summarised by patient selection and operative technique. From an operative point of view, it is essential that a complete CRS is achieved.
