ANZ Journal of Surgery. 2007 May;77 Suppl 1:A88. [Link]
Sim J, Yan TD, Morris DL.
St. George Hospital, New South Wales, Australia.
Purpose: Australia has the highest incidence of mesothelioma worldwide. Compared with traditional treatments using systemic chemotherapy, the combined cytoreductive surgery (CRS) with perioperative intraperitoneal chemotherapy (PIC) has shown improved survival.
Methodology: Fifteen consecutive patients with peritoneal mesothelioma underwent CRS and PIC at the St. George Hospital, Sydney. Clinical and treatment-related data were prospectively collected and reported. The morbidity and mortality rates and overall median survival were evaluated to assess the safety and efficacy of CRS and PIC in the treatment of peritoneal mesothelioma.
Results: There were 10 male and 5 female patients. The median age was 55 years old (range 35-72). The median follow-up was 12 months (range 6-50). Thirteen patients were surveyed regarding asbestos exposure, in which 7 reported a definite asbestos exposure, 3 reported working in high risk occupations and 3 reported minimal exposure risk. The mean operating duration was 9.6 hours.
Rate of re-operation was 7% and mean hospital stay was 23 days. The morbidity and mortality rates were 36% and 7% respectively, with an overall median survival of 86 months (range 1-86). The 1-, 2- and 3-year survivals were 80%, 69% and 55% respectively.
Conclusion: CRS combined with PIC is a treatment option for peritoneal mesothelioma that confers improved survival, when compared with historical controls using systemic chemotherapy.