Completeness of Surgery in Peritoneal Mesothelioma Survival

ByAlex Strauss

How thoroughly surgeons are able to remove a peritoneal mesothelioma tumor appears to be the most influential factor in mesothelioma survival.  

That is the conclusion of a team of surgical oncologists in Baltimore. Their study on peritoneal mesothelioma surgery was just published in The American Surgeon.

The Challenge of Peritoneal Mesothelioma

Peritoneal mesothelioma is a rare form of malignant mesothelioma that occurs on the lining of the abdomen.

Like all forms of mesothelioma, it is caused by exposure to asbestos and is notoriously resistant to systemic chemotherapy.

But peritoneal mesothelioma survival rates have climbed in recent years thanks to a combination cytoreductive surgery (CRS) and heated chemotherapy (HIPEC) that is rinsed through the open abdominal cavity to kill remaining mesothelioma cells.

Influences on Mesothelioma Outcomes

Doctors at the Institute for Cancer Care at Mercy Medical Center in Baltimore, Maryland wanted to know what aspects of a peritoneal mesothelioma patient’s case was likely to have the greatest influence on survival.

They analyzed the cases of 23 patients who underwent CRS/HIPEC for diffuse malignant peritoneal mesothelioma at their facility from 1999 to 2014.

The analysis was used to determine the influence of age, gender, chemotherapy prior to surgery, histological subtype, peritoneal cancer index score, completeness of surgery, and lymph node status on mesothelioma prognosis.  

Completeness of Cytoreduction

After evaluating all aspects of each mesothelioma patient’s case for an average of 31 months, the team determined that only the completeness of surgery was independently associated with mesothelioma survival.

“The completeness of cytoreduction is the most significant prognostic factor for long-term survival,” concludes study author and cancer surgeon Dr. Armando Sardi and his colleagues.

Encouragingly, the report adds, “Patients with diffuse malignant peritoneal mesothelioma may achieve long-term survival when treated with CRS/HIPEC.”

About 500 of the 2,500 malignant peritoneal mesothelioma patients diagnosed in the US each year have peritoneal mesothelioma.

Source:

Aydin, N, et al, “Outcomes of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Mesothelioma: Experience of a Peritoneal Surface Malignancy Center”, December 2015, The American Surgeon, pp. 1253-1259

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