CRS/HIPEC Treatment Helps Double Survival Among Swedish Mesothelioma Patients

A new report suggests that CRS/HIPEC treatment has helped to double the odds of surviving peritoneal mesothelioma in Sweden. 

Researchers collected data from the Swedish National Cancer Registry. A total of 102 peritoneal mesothelioma cases were included from two separate 5-year time periods.

The report shows that, since CRS/HIPEC treatment was introduced in Sweden, overall survival of peritoneal mesothelioma increased from 7 to 15 months. At 5 years, twice as many peritoneal mesothelioma patients were still alive. The researchers conclude that this is likely due, at least in part, to CRS/HIPEC treatment. 

Surviving Peritoneal Mesothelioma

Peritoneal mesothelioma is an aggressive cancer that starts on the membrane lining the abdomen. It is almost always caused by accidental swallowing of microscopic asbestos fibers. Malignant mesothelioma is most common among people who have worked around asbestos in their job. 

Peritoneal mesothelioma grows quickly and can spread to other organs. Before the introduction of CRS/HIPEC treatment, chemotherapy was the main treatment option.

People with peritoneal mesothelioma usually live longer than people with pleural mesothelioma. But both types of mesothelioma are deadly. Chemotherapy alone does not typically extend peritoneal mesothelioma survival by more than a few months. 

The Introduction of CRS/HIPEC Treatment

CRS/HIPEC treatment is a two-part treatment. The first part is cytoreductive surgery (CRS). This is when doctors open the abdomen and remove as much of the cancer as they can see. The goal is to reduce the amount of peritoneal mesothelioma left to deal with. 

The second part of CRS/HIPEC treatment is HIPEC. HIPEC stands for heated intraperitoneal chemotherapy. While the patient is still in the operating room, surgeons rinse the abdomen with a heated solution of cancer-fighting medicine. The goal of HIPEC is to kill any peritoneal mesothelioma cells left behind.

Together, CRS and HIPEC have changed the survival outlook for thousands of peritoneal mesothelioma patients around the world. 

Mixed News About Mesothelioma in Sweden

The new mesothelioma report focused on two groups of patients. The first group included 40 peritoneal mesothelioma patients diagnosed between 1999 and 2003. The second group included 62 patients diagnosed between 2011 and 2015. 

The bad news in those figures is that it shows that peritoneal mesothelioma incidence in Sweden has risen since 1999. But the good news is that, while patients in the first group lived about 7 months after diagnosis, patients in the second group lived for 15 months.

One big difference between the two groups is that CRS/HIPEC treatment was available to the second group. Ten percent of the patients in the second group had the treatment. 

In the first group, before CRS/HIPEC was available, only 14 percent of patients were still alive five years after their mesothelioma diagnosis. But in the second group, 29 percent of patients survived peritoneal mesothelioma for at least five years. 

“Overall survival has increased alongside the introduction of CRS/HIPEC, which may be a contributing factor,” writes researcher Peter Cashin. 

Source:

Cashin, PH, et al, “Peritoneal mesothelioma in Sweden: A population-based study”, September 4, 2019, Cancer Medicine, Epub ahead of print, https://onlinelibrary.wiley.com/doi/full/10.1002/cam4.2436