{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T03:37:54Z","timestamp":1784950674533,"version":"3.55.0"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"CRUK-Accelerator Award"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Transl Oncol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pseudomyxoma Peritonei is characterised by peritoneal metastasis from appendiceal mucinous neoplasms (AMN). The PSOGI classification (2016) categorises PMP into acellular mucin (AM), low-grade mucinous carcinoma peritonei (LGMCP), and high-grade mucinous carcinoma peritonei (HGMCP). This study aimed to determine long-term prognosis based on this classification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>Pathology review from PMP patients with AMNs undergoing cytoreductive surgery and heated intraperitoneal chemotherapy (CRS\u2009+\u2009HIPEC) with curative intent over a 15-year period (2006\u20132021) was undertaken. Patients underwent standardised surveillance. Cox proportional hazards regression models, log-rank test, and Kaplan\u2013Meier method were used to assess overall (OS) and disease-free survival (DFS) based on histopathological peritoneal metastasis grade. DFS was only calculated for patients who had a complete cytoreduction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      290 PMP patients were identified (AM\u2009=\u200934%, LGMCP\u2009=\u200959%, HGMCP\u2009=\u20097%) with median follow-up of 49\u00a0months. Median age was 59\u00a0years (range: 22\u201379), M: F of 1:2.5, peritoneal cancer index median of 18 (range: 0\u201339). Univariate OS hazard ratio (HR) is 2.75 for LGMCP vs AM (95% CI: 1.05 \u20137.21,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.040) and 14.29 for HGMCP vs AM (95% CI: 3.92\u2013 52.11,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). DFS HR\u2009=\u20095.15 for LGMCP (95% CI: 2.19\u201312.10,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and 4.16 for HGMCP (95% CI: 1.03\u201316.80,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.045) with an overall peritoneal metastasis\n                      <jats:italic>p<\/jats:italic>\n                      value\u2009&lt;\u20090.001. Multivariate OS analysis showed that peritoneal histology for HGMCP remained a significant predictor of poor prognosis for OS (HR: 5.54, 95% CI: 1.32\u201323.25,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019), whilst LGMCP did not demonstrate a significant association (HR: 1.59, 95% CI: 0.59\u20134.26,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.359).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Peritoneal metastasis histopathological grade predicts outcome for patients with PMP from AMN following CRS\u2009+\u2009HIPEC independent of primary histology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12094-025-04112-8","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T16:11:53Z","timestamp":1768925513000},"page":"2739-2748","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Peritoneal metastasis histological grade independently predicts outcome in pseudomyxoma peritonei treated with curative surgery"],"prefix":"10.1007","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7798-8780","authenticated-orcid":false,"given":"Awen","family":"Hasan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bipasha","family":"Chakrabarty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Kearsey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raghavendar","family":"Nagaraju","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malcolm","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Renehan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Fish","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Sutton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Wild","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chelliah","family":"Selvasekar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamish","family":"Clouston","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Barriuso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah Theresa","family":"O\u2019Dwyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3765-2702","authenticated-orcid":false,"given":"Omer","family":"Aziz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,20]]},"reference":[{"issue":"5","key":"4112_CR1","doi-asserted-by":"publisher","first-page":"2819","DOI":"10.1245\/s10434-020-09560-w","volume":"28","author":"B Rufi\u00e1n-Andujar","year":"2021","unstructured":"Rufi\u00e1n-Andujar B, Valenzuela-Molina F, Rufi\u00e1n-Pe\u00f1a S, Casado-Adam \u00c1, S\u00e1nchez-Hidalgo JM, Rodr\u00edguez-Ortiz L, et al. 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