New Surgical Technique May Support Long-Term Peritoneal Mesothelioma Survival

One of the nation’s top mesothelioma doctors says long-term peritoneal mesothelioma survival is possible with a far-reaching new surgical technique.

Dr. Paul Sugarbaker is a surgeon with the Washington Cancer Institute in Washington, DC. He has studied peritoneal mesothelioma for decades. 

In a new report, he outlines a case of long-term peritoneal mesothelioma survival in a female patient. The patient had cytoreductive surgery. The surgery included resection of the colonic mesentery. This is tissue that is not normally part of peritoneal mesothelioma surgery. 

The case report shows the patient is still cancer-free four years after surgery with an “excellent” quality of life. 

The Challenge of Peritoneal Mesothelioma

Every year, about 2,500 Americans receive a diagnosis of mesothelioma. Peritoneal mesothelioma accounts for about a fifth of those cases. 

Most peritoneal mesothelioma patients have lived or worked around asbestos for an extended period of time. The prognosis is not usually very good. Mesothelioma tumors spread out quickly across the membrane that lines the abdomen. 

Long-term peritoneal mesothelioma survival is not common. Most patients have a life expectancy between 12 and 18 months. 

But new treatment advances are improving the odds of surviving mesothelioma. Many surgeons now follow the resection with a rinse of heated chemotherapy drugs. This is called HIPEC. It’s goal is to kill residual cells that could seed new tumors. 

Removing Key Tissues Leads to Long-Term Peritoneal Mesothelioma Survival

In his new report, Dr Sugarbaker details his new approach to removing at-risk tissue in the abdomen. The patient’s peritoneal mesothelioma treatment started with a complete cytoreductive surgery. 

“This required visceral resections, parietal peritonectomy, peritonectomy of the small bowel and its mesentery, and a peritoneal resection of the colonic mesentery with sparing of the major vasculature of the large bowel,” writes Dr. Sugarbaker in the International Journal of Surgery Case Reports.

The colonic mesentery is a double fold of peritoneal membrane. It attaches the intestine to the abdominal wall and helps hold it in place. Resection of this membrane is not a standard part of peritoneal mesothelioma surgery. 

But Dr. Sugarbaker’s success with this approach suggests that resection of the colonic mesentery, along with advanced techniques like HIPEC, has the potential to promote long-term peritoneal mesothelioma survival. 

“Malignant peritoneal mesothelioma was in the past a disease of limited survival without effective treatment options,” he writes. “A sequence of cytoreductive surgical procedures and regional chemotherapy treatments has made long-term survival possible.”

Australian Paul Kraus is an example of someone who has survived peritoneal mesothelioma for decades. Paul’s doctors told him he had just months to live but 20 years later he is still sharing his story of survival with other patients. To read about Paul’s experience of long-term peritoneal mesothelioma survival, CLICK HERE to request a free copy of his book.

Source:

Sugarbaker, P, “Peritonectomy of the colonic mesentery. Case report of a new surgical technology”, September 6, 2021, International Journal of Surgery Case Reports, Online ahead of print, https://www.sciencedirect.com/science/article/pii/S2210261221008713?via%3Dihub