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Second Treatment Effective for Peritoneal Mesothelioma


There is some good news from the Wake Forest School of Medicine for patients with peritoneal mesothelioma. In many cases, after a mesothelioma patient has been treated with one therapy, that therapy is not used again.  This means that when a treatment fails, many mesothelioma patients often run out of treatment options.

But researchers at Wake Forest have confirmed that, for patients whose peritoneal mesothelioma recurs after surgery and hyperthermic intraperitoneal chemotherapy (HIPEC), a second treatment may be just as effective at prolonging survival. Peritoneal mesothelioma occurs in the lining of the abdomen.  It is the result of ingestion or inhalation of asbestos fibers.

Cytoreductive (CRS) surgery involved a scraping away of the tumor from the peritoneum. When it is followed  by a wash of heated chemotherapy drugs through the open abdominal cavity (HIPEC), it has been shown to slow the progression of the disease and improve survival.

Wake Forest researchers evaluated sixty-two patients – including seven with peritoneal mesothelioma – who had second CRS/HIPEC treatments. Median survival after the second treatment was 21.8 months for mesothelioma. Although 48.4% of patients did have significant complications after surgery, only 3.2% died as a result of the procedure. Patients who had a longer period of time between the two procedures survived longer than those whose CRS/HIPC treatments were closer together.

“In experienced tertiary centers and for selected patients,” concluded the study, “a repeat CRS/HIPEC procedure has morbidity and mortality similar to the initial cytoreduction.” Survival depends on how complete the second CRS/HIPEC treatment is and “favorable biology of the tumor.”


Vatanopoulos, KI et al, “Outcomes of Repeat Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for the Treatment of Peritoneal Surface Malignancy”, May 25, 2012, Journal of the American College of Surgeons, Epub ahead of print.

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