Study designs of evaluations included in the review
Experimental and observational studies were eligible for inclusion. All of the included studies were observational case series without control groups.
Specific interventions included in the review
Studies of CRS in combination with PIC (administered within 7 days of surgery) as described by Sugarbaker (reference given) were eligible for inclusion. Studies that evaluated surgical debulking alone for PMP were excluded. CRS comprised various peritonectomy procedures and visceral resections. PIC regimens included intraperitoneal hyperthermic chemotherapy and/or early post-operative intraperitoneal chemotherapy. All of the included studies were set in tertiary referral centres.
Participants included in the review
Studies of patients with PMP were eligible for inclusion. Studies in patients with peritoneal surface malignancy but not specifically PMP were excluded. PMP was defined clinically on the basis of intra-operative findings of localised or generalised accumulations of mucinous tumours in the peritoneal cavity. In the included studies, PMP originated from exclusively or mainly appendiceal epithelial neoplasms; 2 studies did not report the origin of PMP.
Outcomes assessed in the review
Studies that assessed survival, disease status, morbidity and mortality, or quality of life were eligible for inclusion. In the review, outcomes that were reported in more than one trial were assessed. The review assessed survival (median and at 1, 2, 3, 5 and 10 years), disease status (no evidence, alive with disease or died from disease), morbidity, haematological toxicity, blood loss, duration of operation, reoperation rate, mortality and duration of hospital stay. None of the included studies evaluated quality of life among patients with PMP only.
How were decisions on the relevance of primary studies made?
The authors did not state how the papers were selected for the review, or how many reviewers performed the selection.