Risk Factors for Pseudomyxoma Peritonei in Appendiceal Mucinous Neoplasms: A Single-Center Experience

INTRODUCTION: Appendiceal mucinous neoplasms (AMNs) are rare tumors with the potential to progress to pseudomyxoma peritonei (PMP). Identification of prognostic factors may improve surgical management and follow-up strategies. OBJECTIVE: This study aimed to analyze clinicopathological factors associated with the development of PMP in patients with AMNs treated at a tertiary care hospital in Mexico. METHODS: A retrospective study was conducted in Hospital Médica Sur, Mexico City, Mexico, including 30 patients with histologically confirmed AMNs between 2018 and 2023. Clinical, surgical, histological, and laboratory variables were analyzed. Bivariate analyses and binary logistic regression models were performed to identify factors associated with the development of PMP. RESULTS: Appendiceal perforation was the only factor significantly associated with the development of PMP, as the absence of perforation was linked to significantly lower odds of disease (odds ratio (OR): 0.090; 95% confidence interval (CI): 0.010-0.798; p = 0.031). Histological subtypes other than low-grade appendiceal mucinous neoplasm (LAMN) showed a nonsignificant trend toward association (p = 0.076). CONCLUSION: Appendiceal perforation was the main factor associated with the development of PMP in this cohort. Its identification may help guide surgical decision-making and individualized postoperative surveillance strategies.