An international research study including patients from 11 countries may help reveal new and better ways to predict peritoneal mesothelioma prognosis.
Right now, doctors use three primary criteria to determine peritoneal mesothelioma prognosis. Those are how much cancer was in the abdomen at the time of surgery, how complete the surgery was, and the tumor grade.
But about 70 percent of people treated for peritoneal cancers like mesothelioma have recurrent disease. The goal of the new study is to find more prognostic factors. Knowing these factors could help doctors make better choices about which patients are most likely to benefit from cytoreductive surgery (CRS).
The CRS/HIPEC Procedure for Mesothelioma
Peritoneal mesothelioma occurs on the lining of the abdomen. Peritoneal mesothelioma prognosis is generally better than it is for pleural mesothelioma. Advances in cytoreductive surgery (CRS) is a big reason for that.
During cytoreduction, surgeons try to remove all the malignant tissue they can see. This is often followed by heated intraperitoneal chemotherapy (HIPEC). HIPEC involves rinsing the abdomen with a warm solution of cancer-killing chemicals. This happens immediately after CRS as a way to kill any remaining mesothelioma cells.
Mesothelioma patients who have CRS/HIPEC usually live longer than those who do not. CRS/HIPEC has improved peritoneal mesothelioma prognosis. But the cancer still recurs for most people.
One problem is that right now peritoneal mesothelioma prognosis is based on factors that doctors can only know after surgery. The international research team hopes to identify more presurgical prognostic factors for people with peritoneal cancers. They hope this will lead to more informed treatment decisions and better outcomes.
The Future of Peritoneal Mesothelioma Prognosis
The new international study will include a variety of people with peritoneal (abdominal lining) cancers who are having CRS.
Their peritoneal cancer may have started in another place in the body, such as the colon, appendix, or ovaries. Or it could have originated on the peritoneal lining like peritoneal mesothelioma.
Researchers will analyze patient demographics as well as their clinical information. They will look at their imaging studies, the details of their surgeries, and their lymph node involvement. They will also assess the pathology of their tumors.
The answers could have a big impact on how doctors determine peritoneal mesothelioma prognosis in the future.
“A correlation between the surgical, radiological and pathological findings will be performed and the impact of these potential prognostic factors on progression-free and overall survival determined,” states the report.
The large-scale peritoneal surgery study includes research centers in India, France, Italy, the US, The Netherlands, and others. Peritoneal mesothelioma is the rarest of the cancers they plan to study. An estimated 500 Americans receive a peritoneal mesothelioma diagnosis each year.
Bhatt, A, et al, “Patterns of peritoneal dissemination and response to systemic chemotherapy in common and rare peritoneal tumours treated by cytoreductive surgery: study protocol of a prospective, multicentre, observational study”, July 5, 2021, BMJ Open, https://bmjopen.bmj.com/content/11/7/e046819