Is it safe to have cytoreductive surgery and intraoperative chemotherapy for mesothelioma in a center that does not do a lot of these procedures?
Previous studies have suggested that the best outcomes in pleural mesothelioma treatment are found in centers that do the highest volume of mesothelioma surgeries.
But a new report from a group of cancer doctors in Italy suggests that mesothelioma surgery can be done effectively, even in a small medical center with fewer mesothelioma patients.
Cytoreductive Mesothelioma Surgery
Mesothelioma patients in the new study underwent a combination of pleurectomy/decortication surgery and hyperthermic intrapleural chemotherapy (HITHOC) to treat their mesothelioma.
Pleurectomy/decortication involves the removal of the diseased pleural lining and other tissues that are at risk for the spread of mesothelioma. The surgery leaves the lungs in place.
During HITHOC, a heated solution of chemotherapy drugs is washed through the pleural cavity for about an hour in an effort to destroy any residual mesothelioma cells and prevent mesothelioma recurrence.
Mesothelioma Treatment Results
Doctors at the Policlinico Hospital in Catania, Italy performed the P/D and HITHOC procedure on six consecutive mesothelioma patients.
To be included in the small prospective study, patients had to have a confirmed mesothelioma diagnosis, early stage disease, and good overall health, also know as “performance status”.
Just over 16 percent of patients developed complications from the procedure, but none of these mesothelioma patients died as a result of the procedure.
Validation for Small Cancer Centers
More importantly, average mesothelioma survival among these treated patients was 21.5 months – significantly longer than the typical mesothelioma life expectancy of about a year.
The authors of the new mesothelioma study say their experiment not only confirms that P/D and HITHOC are good therapeutic options for multimodality mesothelioma treatment, but that these procedures can be safely done in smaller, low volume centers like theirs.
To confirm their results, the team calls for a randomized controlled clinical trial.
In the US, an estimated 2,500 people will face a mesothelioma diagnosis in the next year. Despite continuing medical advances, there is no cure.
Migliore, M, et al, “Pleurectomy/decortication and hyperthermic intrapleural chemotherapy for malignant pleural mesothelioma: initial experience”, November 2015, Future Oncology, pp. 19 – 22.