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Preventing recurrence of diffuse malignant peritoneal mesothelioma
Joshua C Leinwand1, John A Chabot1, Michael D Kluger1
1a Department of Surgery , Columbia University Medical Center , New York , NY , USA.
Expert Review of Anticancer Therapy
|August 4, 2016
Summary
Cytoreductive surgery with intraperitoneal chemotherapy offers survival benefits for diffuse malignant peritoneal mesothelioma (DMPM). Close surveillance and strategies like dwell chemotherapy are crucial due to high recurrence rates.
Area of Science:
- Surgical Oncology
- Medical Oncology
- Gastroenterology
Background:
- Diffuse malignant peritoneal mesothelioma (DMPM) is aggressive with poor prognosis.
- Systemic therapy offers limited benefit for DMPM.
- Cytoreductive surgery (CRS) with intraperitoneal chemotherapy (IPC) is the standard of care but has high recurrence rates.
Purpose of the Study:
- To review patient selection and operative goals for CRS with IPC in DMPM.
- To assess outcomes and supporting data for platinum-based IPC.
- To outline surveillance and re-operation strategies for DMPM recurrence.
Main Methods:
- Literature review via Medline search.
- Assessment of pharmacokinetics for dwell IPC.
- Review of clinical, imaging, and laboratory surveillance methods.
Main Results:
- CRS/IPC provides survival benefits in selected DMPM patients.
- High locoregional recurrence rates necessitate vigilant post-operative surveillance.
- Dwell IPC and repeat CRS/IPC are strategies for managing recurrent DMPM.
Conclusions:
- CRS/IPC is a beneficial treatment for selected DMPM patients.
- Close surveillance is essential post-operatively due to high recurrence risk.
- Strategies to prevent and treat recurrence include dwell IPC and re-operation.
