Mesothelioma Survival Impacted by Lack of Surgery

A team of surgical oncologists say failure to treat peritoneal mesothelioma with surgery is costing too many patients their lives. Researchers from the Medical College of Wisconsin studied survival statistics for more than 1,500 patients with malignant peritoneal mesothelioma, a form of mesothelioma that occurs in the abdomen. They concluded that many more of them could survive longer if they were treated with surgery.

Using the Surveillance, Epidemiology and End Results (SEER) database, the research team identified 1,591 patients diagnosed with peritoneal mesothelioma between 1973 and 2010. The median age of the studied patients was 74 years and most had metastatic disease, meaning that their mesothelioma had spread beyond the peritoneal membrane that lines the abdomen.

Of those 1,591 peritoneal mesothelioma patients, 980 (61.6%) did not receive surgical treatment, even though multiple studies have shown that surgery offers a significant survival benefit. According to the Wisconsin researchers, patients with metastatic peritoneal mesothelioma who were treated with radical cytoreduction had an overall survival rate that was four times higher than those who did not have surgery (20 months vs. 4 months). Even those patients who had a more limited form of surgery tended to experience improved survival.

“In the current era, approximately three of every five patients do not receive surgery when diagnosed with malignant peritoneal mesothelioma,” notes research resident John Miura, MD, the study’s lead author. “The opportunity to improve patient survival with surgical therapy is lost in a significant number of malignant peritoneal mesothelioma patients.”

For peritoneal mesothelioma patients considering surgery, it is also important to note that survival rates are better now than they used to be. The study found that patients who had peritoneal mesothelioma surgery between 1991 and 1995 had a median survival of 15 months, while those who underwent operations between 2006 and 2010 survived for a median of 38 months.

Peritoneal mesothelioma is a less common form of this rare cancer. About 500 of the 2,500 mesothelioma cases diagnosed in the U.S. each year occur on the peritoneum. The more common form of the disease occurs on the pleural lining around the lungs. All forms of mesothelioma are associated with exposure to asbestos.

Source:
Miura, JT et al, “Current Trends in the Management of Malignant Peritoneal Mesothelioma”, May 14, 2014, Annals of Surgical Oncology, Epub ahead of print