{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T19:08:36Z","timestamp":1769800116664,"version":"3.49.0"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Pseudomyxoma peritonei (PMP), generally spread of low grade appendiceal mucinous neoplasm (mucinous appendix neoplasms) into the abdominal cavity, is conventionally treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC). Prognostic factors of small cohort sizes remain incomplete and conflicting. This large-scale study aimed to characterize long-term survival outcomes and identify prognostic factors in PMP patients following CRS-HIPEC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study of 432 consecutive PMP patients treated with CRS-HIPEC at Aerospace Center Hospital (Beijing, China) from June 2014 to December 2020. Overall survival (OS) served as the primary endpoint, with event-free survival (EFS) as the secondary endpoint. Multivariable Cox proportional hazards models were employed to identify independent prognostic factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      With median survival durations of 56 months (OS) and 45 months (EFS), cumulative mortality and event incidence reached 21.4% and 32.4%, respectively. Independent predictors for poorer OS included: preoperative raised tumor markers (hazard ratio [HR]\u2009=\u20094.90\u201310.20; 95% confidence interval [95% CI]: 1.11\u201346.67;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05), completeness of cytoreduction (CC) score (HR\u2009=\u20093.37\u20139.41; 95% CI: 1.05\u201316.37;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05), and high-grade PMP (HR\u2009=\u20091.80; 95% CI: 1.10, 2.93;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.019). EFS was significantly associated with preoperative Barthel index (HR\u2009=\u20090.86; 95% CI: 0.74, 0.98;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.019) in addition to the aforementioned factors. Intraoperative hypotension and hyperthermia were not associated with both OS and EFS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Key factors impacting outcomes of patients with PMP of mucinous appendix neoplasms included preoperative elevated tumor markers, Barthel index, CC-score, and the PMP histology, without intraoperative hypotension and hyperthermia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1692847","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T06:41:19Z","timestamp":1769755279000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-term outcomes of pseudomyxoma peritonei after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy and its relevant risk factors in China: a retrospective study"],"prefix":"10.3389","volume":"13","author":[{"given":"Shuncai","family":"Gao","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Aerospace Center Hospital","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Peking University School and Hospital of Stomatology","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ziyang","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Stomatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junwei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Changde Hospital, Xiangya School of Medicine, Central South University (The 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