A new published study suggests that peritoneal mesothelioma patients treated at academic medical centers survive much longer than those who get their care at community hospitals.
The study was conducted by Harvard Medical School researchers at Brigham and Women’s Hospital in Boston.
Peritoneal mesothelioma is a rare and aggressive cancer of abdominal membranes. There is no known cure. The new study compared outcomes and survival among more than 2,600 mesothelioma patients. Patients were treated at high-volume academic hospitals or community cancer centers.
The results suggest that academic medical centers consistently provide more advanced and potentially life-extending care for this complex cancer.
Experience is Critical for Mesothelioma Care
Malignant mesothelioma is the name for cancers that occur on internal membranes. It is almost always caused by exposure to asbestos. Usually that exposure happened on the job. Often, it occurred decades before.
Peritoneal mesothelioma accounts for about 500 cases of mesothelioma in the US every year. Many doctors who do not work at academic medical centers have never seen a single case. This is problematic because peritoneal mesothelioma is difficult to treat.
The gold standard treatment is cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). During CRS/HIPEC, surgeons remove as much mesothelioma as they can from the abdomen. Then they rinse the abdomen with heated chemotherapy drugs to kill residual cells.
CRS/HIPEC requires a high level of expertise. Experienced surgeons produce the best outcomes. They are also more likely to be working at academic medical centers than in community cancer hospitals.
Survival at Community Cancer Centers vs Academic Medical Centers
The study included 2,682 peritoneal mesothelioma patients. The data came from the National Cancer Center database. Patients received mesothelioma treatment between 2004 and 2016. Forty-seven percent were treated at an academic medical center. Fifty-two percent were treated at a community hospital.
Almost 43 percent of patients treated at academic facilities had mesothelioma surgery (PD or EPP). Even though it is the standard of care, only 20 percent of community hospital patients had surgery.
Twenty-nine percent of the academic medical center patients had HIPEC after surgery. This only happened 10 percent of the time at community cancer centers.
Most importantly, the median overall survival for patients treated at high-volume centers was two years and eight months. That is a sharp contrast to the 11.6 months median overall survival among those treated locally. Nearly 30 percent of peritoneal mesothelioma patients treated at academic medical centers were still alive five years later. At community hospitals, that figure was only 18.3 percent.
“Patients at academic centers underwent surgery and received chemotherapy on the same day as surgery more frequently than those at community centers, suggesting that malignant peritoneal mesothelioma patients may be better served at experienced academic centers,” concludes lead author and general surgeon Vanessa Welten, MD, MPH.
If you need help finding a mesothelioma specialist in your region, CLICK HERE to get started.
Welten, V, et al, “Survival Outcomes for Malignant Peritoneal Mesothelioma at Academic Versus Community Hospitals”, July 21, 2021, Journal of Gastrointestinal Surgery, https://link.springer.com/article/10.1007%2Fs11605-021-05084-0