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Outcomes of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal mesothelioma: the Australian experience

Monday, November 17th, 2008.

Journal of Surgical Oncology. 2009 Feb 1;99(2):109-13. [Link]

Chua TC, Yan TD, Morris DL.

Department of Surgery, University of New South Wales, St George Hospital, Kogarah, Sydney, NSW, Australia.

Abstract

Aims: Peritoneal mesothelioma is a rapidly progressing malignancy with a median survival of 6-12 months. Palliative surgery, chemotherapy and radiotherapy are futile and have not shown to improve survival. This paper reports the outcomes of cytoreductive surgery (CRS) and Hyperthermic intraperitoneal chemotherapy (HIPEC) for the treatment of this disease.

Patients and Methods: An observational study of 20 patients with peritoneal mesothelioma treated with CRS and HIPEC at the St George Hospital, Sydney, Australia. Survival analysis was performed using the Kaplan-Meier method and comparison using the Log Rank test.

Results: There were six females. The mean age was 55.7 (9.0) years. The median survival was 29.5 (0.46-87.2) months with 1- and 3-year survival of 78.2% and 46.3%, respectively. Survival was found to be influenced by completeness of cytoreduction (P = 0.02) and histological subtype (P = 0.01). Patients with epitheloid peritoneal mesothelioma who had a CC0 had a median survival of 87.2 months.

Conclusion: CRS and HIPEC is a treatment option for peritoneal mesothelioma. Patients with epithelioid tumor who undergo complete cytoreduction may potentially benefit from this procedure.

Keywords: cytoreductive surgery, hyperthermic intraperitoneal chemotherapy, mesothelioma, peritoneal neoplasms, peritonectomy

Glossary

oncology
(on-call-o-jee) the branch of medicine concerned with the diagnosis and treatment of cancer.
chemotherapy
(key-mo-THER-uh-pee) treatment with drugs to destroy cancer cells. Chemotherapy is often used with surgery or radiation to treat cancer when the cancer has spread, when it has come back (recurred), or when there is a strong chance that it could recur.
tumor
an abnormal lump or mass of tissue. Tumors can be benign (not cancerous) or malignant (cancerous).
mesothelioma
a tumor derived from mesothelial tissue, such as the peritoneum (lining the abdomen) or pleura (lining the lungs). More on mesothelioma.
peritoneal
(pair-uh-tuh-nee-al) the serous membrane that lines the cavity of the abdomen. (More on Peritoneal Mesothelioma.)
intraperitoneal chemotherapy
(IPC) a form of regional chemotherapy; the flooding of the abdominal cavity with chemotheraputic drugs to target the cancer cells directly. It is sometimes heated to improve absorption of the anticancer drugs by the cancerous cells and because heat itself can kill cancer cells.

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