Outlook Better for Women with Peritoneal Mesothelioma

Women with diffuse malignant peritoneal mesothelioma have a better chance of success with surgery and chemotherapy than their male counterparts.

That is the conclusion of researchers at the Baird Institute for Applied Heart and Lung Surgical Research in Sydney, Australia.  Using the records of 294 peritoneal mesothelioma patients treated at multiple institutions in the past two decades, the researchers set out to measure the impact of gender on overall survival after treatment. Peritoneal mesothelioma is a type of mesothelioma that spreads quickly across the mesothelial lining of the abdomen. Asbestos exposure is its only known cause.

Because of the aggressive nature of the disease, mesothelioma is typically treated using a multi-modal approach. The subjects of the Australian study had all been treated using a combination of cytoreductive surgery (CRS) and a chemotherapy ‘wash’ of the peritoneal cavity known as perioperative intraperitoneal chemotherapy.  The process has been shown to improve survival outcomes in both peritoneal and pleural mesothelioma patients.

“Female patients were shown to have a significantly improved survival outcome than male patients,” the Australian researchers write of their findings in the Annals of Oncology.  Although older female patients did not respond as well as younger women, both groups fared better than men, for whom age appeared to have little impact on treatment response. The news was most promising for women whose peritoneal mesothelioma was diagnosed at a low stage.  They were found to have “a very favorable long-term outcome after combined treatment.”

The new study is not the first to explore the role of gender in surviving diffuse malignant peritoneal mesothelioma. A smaller 2006 study reached similar conclusions.  It found that, not only was the 5-year survival rate better for women than men (63% vs. 42%), but the tumor cells themselves were different with smaller nuclei and a granular pattern to their protein arrangement.

In their conclusion, the authors of the latest study call for an improved understanding of the role of estrogen in the pathogenesis of diffuse malignant peritoneal mesothelioma which they say may not only improve survival predictions, but may also open the door to the future therapeutic use of hormones in the treatment of mesothelioma.

Sources:

Cao, C et al, “Importance of gender in diffuse malignant peritoneal mesothelioma”, November 4, 2011, Annals of Oncology, Epub ahead of print.

Yan, TD et al, “Sex difference in diffuse malignant peritoneal mesothelioma”, December 2006, The British Journal of Surgery, pp. 1536-42.