Outcomes of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy for peritoneal mesothelioma and predictors of survival

We present the outcomes of this treatment strategy in a UK peritoneal malignancy national referral centre

Syeda Nadia Shah Gilani

2018

Scholarcy highlights

  • The incidence of mesothelioma in developed countries varies from 14 to 35 cases per million per year and peritoneal mesothelioma accounts for 10–30% of all cases
  • Survival rates after maximal tumour debulking were significantly higher in patients with low-grade mesothelioma versus diffuse malignant peritoneal mesothelioma, with median overall survival 85.1 months and 29.0 months, respectively
  • Once the diagnosis has been made there are few chemotherapy options with no new systemic drug regimes in the last decade since Vogelzang demonstrated that the addition of pemetrexed to cisplatin improved survival in patients with pleural mesothelioma
  • Systemic treatment using this combination of cisplatin and pemetrexed is associated with median overall survival of just 13 months
  • The present study shows that, in DMPM, outcomes after complete Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy is influenced by the Ki-67 proliferation index; patients with a proliferation index !7% had significantly decreased survival rates
  • In contrast to Ki-67 proliferation index, Peritoneal Cancer Index score was not associated with outcome after complete cytoreduction. This finding is in contrast to a recent study of 117 patients with DMPM, where PCI was found to be an independent predictor of survival after CRS and HIPEC, along with the Ki-67 proliferation index
  • The treatment is not achieved, is of benefit to patients with either lowof peritoneal carcinomatosis of colorectal cancer with complete grade or malignant mesothelioma and at present is the only cytoreductive surgery and hyperthermic intraperitoneal peroperatreatment which has the potential for cure

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