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Treatment Combination Used Most for Mesothelioma

Treatment Combination Used Most for Mesothelioma

Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is being used by doctors to treat malignant peritoneal mesothelioma (MPM) more often. This is the finding of a study published in the Annals of Surgical Oncology.

This is promising news because research has shown the CRS-HIPEC can be an effective treatment for patients with MPM.

Mesothelioma Caused by Asbestos Exposure

MPM is caused by exposure to a toxic material called asbestos. Most doctors believe it is caused from ingestion of asbestos fibers and that microscopic asbestos fibers become embedded in the abdomen. After about 20-50 years, these fibers can cause inflammation and mutations that ultimately caused tumors to form.

This cancer occurs in less than 1,000 people in the United States every year. Diagnosis typically occurs in people over the age of 65, but peritoneal mesothelioma has occurred in people much younger.

CRS-HIPEC Treatment Option

CRS-HIPEC combines two treatments to improve the condition of a patient with MPM. CRS involves removing as much of the cancerous tissue as possible from the abdomen. The second part of the treatment, HIPEC, uses chemotherapy applied at a high temperature to kill any remaining cancer cells.

In this newly published study, the researchers wanted to find out how people with MPM were being treated and how long they survived. They used data from 2,683 patients from the National Cancer Database who were treated for MPM between 2004 to 2018.

They found that overall, almost 19% of patients received CRS-HIPEC while about 21% didn’t get any treatment.

Over time, more patients started receiving CRS-HIPEC and fewer patients received no treatment.

The average survival time was about 19.5 months. The factors that influenced survival included the type of treatment, the type of cancer, gender, age, race, other health conditions, insurance, and the type of hospital.

Although the year of diagnosis seemed to have an impact on survival, it was mostly because of the treatment received.

The researchers felt hopeful that more MPM patients were being treated with CRS-HIPEC. However, they also expressed concern that many patients were not receiving treatment at all.


Calthorpe L, Romero-Hernandez F, Casey M, et al. National Practice Patterns in Malignant Peritoneal Mesothelioma: Updates in Management and Survival [published online ahead of print, 2023 May 4]. Ann Surg Oncol. 2023;10.1245/s10434-023-13528-x. doi:10.1245/s10434-023-13528-x. https://pubmed.ncbi.nlm.nih.gov/37140748/

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