Can repeated mesothelioma surgeries extend peritoneal mesothelioma survival? A new case report out of Japan suggests the answer may be yes.
The article recounts the case of a patient with peritoneal mesothelioma. Each time surgeons removed a mesothelioma tumor, a new one would occur in a different location. The man had four separate mesothelioma surgeries over the course of five years.
Repeated mesothelioma surgeries are not the norm. But this treatment approach may be the reason for the man’s unusually long mesothelioma survival.
Surgical Treatment of Peritoneal Mesothelioma
Peritoneal mesothelioma accounts for about 20 percent of mesothelioma cases in the US each year. It occurs on the membrane that surrounds the abdominal organs. Because it sits so close to these organs, it is easy for mesothelioma to spread.
Peritoneal mesothelioma surgery can involve removal of all or part of the peritoneal membrane. But it can also involve removal of other affected tissues.
In the last decade, it has become standard to rinse the abdomen with heated chemotherapy drugs (HIPEC) after surgery. This can help keep new tumors from forming and reduce the need for repeated mesothelioma surgeries.
Surgery combined with chemotherapy and sometimes radiation is now the gold standard mesothelioma treatment.
If peritoneal mesothelioma recurs after surgery, patients may have systemic chemotherapy. Surgeons do not usually perform repeated mesothelioma surgeries.
Recurrence Leads to Repeated Mesothelioma Surgeries
The newly-reported case of repeated mesothelioma surgeries appears in a Japanese medical journal. The 63-year-old patient had a tumor removed from his gastrointestinal tract in 2011. Tests showed that the tumor was malignant mesothelioma.
A few months later, the man had another tumor removed from an area near the liver. This one was also peritoneal mesothelioma.
Repeated mesothelioma surgeries in 2012 and 2015 involved tumors near the small bowel and one in the liver. Each time, the tumors turned out to be peritoneal mesothelioma.
“There is no record of multiple excision of malignant peritoneal mesothelioma for recurrences,” write the study authors. “In this case, the cause of long survival was considered to be the excision of recurrent tumors.”
Mesothelioma Surgery and Symptom Management
It is not always possible to remove all of the cancer during peritoneal mesothelioma surgery. If cancer has already spread too much, surgery may help reduce mesothelioma symptoms like abdominal pain and bloating.
Repeated mesothelioma surgeries may not be appropriate for every patient. But the Japanese case shows that it may be possible to extend mesothelioma survival for some.
The prognosis for peritoneal mesothelioma is usually better than other forms of mesothelioma. The average life expectancy for peritoneal mesothelioma patients is about a year. But thanks to new surgical techniques and HIPEC, some patients are living five years or longer.
Takahashi, D, et al, “[A Case of Malignant Peritoneal Mesothelioma Resected Four Times in Five Years]”, October 2019, Gan To Kagaku Ryoho, pp. 1641-1643, https://www.ncbi.nlm.nih.gov/pubmed/31631161