Malignant abdominal mesothelioma: defining the role of surgery
Journal of Surgical Oncology. 2009 Jan 1;99(1):51-7. [Link]
RodrÃguez D, Cheung MC, Housri N, Koniaris LG.
Division of Surgical Oncology, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
Abstract
Objective: Determine the role of surgery for patients with malignant abdominal mesotheliomas (MAMs).
Methods: The Surveillance, Epidemiology, and End Results (SEER) database (1973-2005) was queried.
Results: Overall, 10,589 cases of malignant mesotheliomas were identified. Of these, 9,211 cases were thoracic (TM) and 1,112 cases were MAM (10.5%). Patients with TM presented with more localized disease than those patients with MAM (P < 0.001). MAM more often affected younger patients (63 years vs. 71 years) (P < 0.001). The annual incidence of MAM was approximately 1.00 case per 100,000 in 2005. Overall median survival for MAM patients was 8 months, with a significant difference between women and men (13 months vs. 6 months, respectively) (P < 0.001). Patients who successfully underwent surgical resection had a considerably longer median survival (20 months vs. 4 months, P < 0.001) as well as a significantly higher 5-year survival (28% vs. 12%, P < 0.001). Multivariate analysis identified that a poorly differentiated tumor grade, failure to undertake surgical resection, advanced age, and male gender were all independent predictors of poorer outcome.
Conclusion: Surgical extirpation of MAM may be associated with significantly improved survival. All patients with MAM should be evaluated for potential surgical resection.
Keywords: malignancy, cancer, survival, surgery, peritoneal mesothelioma, thoracic mesothelioma, pleural mesothelioma, SEER, abdominal mesothelioma, outcomes
