Postoperative follow-up compliance and survival analysis in pseudomyxoma peritonei patients treated with CRS and HIPEC: a six-year retrospective study

Abstract

Abstract Background PMP is a rare clinical syndrome characterized by the accumulation of mucinous material in the peritoneal cavity. The combination of CRS and HIPEC is the standard treatment, known to improve survival outcomes. However, follow-up adherence is critical for early detection of recurrence and extending survival. This study is the first to specifically investigate postoperative follow-up adherence in PMP patients treated with CRS and HIPEC. Aims To explore the socio-demographic and clinical determinants of follow-up adherence and its impact on survival in PMP patients treated with CRS and HIPEC. Methods This single-center, six-year retrospective study included 111 PMP patients who underwent CRS and HIPEC. Patients were categorized into compliant (control) and non-compliant (study) groups. Follow-up was initiated by the physician, with patients returning for regular visits as recommended. Kaplan-Meier analysis was used to evaluate survival outcomes, while univariate analysis identified factors influencing follow-up adherence. Results Among 111 patients, 32 died by August 2024, with 1-, 3-, and 5-year survival rates of 88%, 66%, and 53%, respectively. High PCI scores (P < 0.001) and poorer histopathological types (P = 0.002) were significant predictors of reduced survival. Non-compliance with follow-up showed a trend toward decreased survival (P = 0.07). Significant risk factors for non-compliance included lower ASA scores (P = 0.020), middle- and low-income levels (P = 0.034), and parental survival status (P = 0.003). Middle- and low-income patients also experienced longer delays in seeking medical advice and had fewer cases detected through routine health screenings (P = 0.019). Conclusions Follow-up compliance has a potential impact on survival outcomes in PMP patients treated with CRS and HIPEC. Socio-demographic factors significantly influence adherence, highlighting the need for tailored interventions to enhance patient management.

Keywords

• Cytoreductive surgery (CRS)
• Follow-up compliance
• Hyperthermic intraperitoneal chemotherapy (HIPEC)
• Pseudomyxoma peritonei (PMP)
• Psycho-oncology
• Risk factors