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Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy for peritoneal mesothelioma: patient selection

Laura M Enomoto1, Perry Shen1, Edward A Levine1

  • 1Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston Salem, NC 27157, USA.

Cancer Management and Research
|June 14, 2019
PubMed

Insights

Malignant peritoneal mesothelioma (MPM) is a rare cancer. Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) offers significant survival benefits and palliation for MPM patients.

Area of Science:

  • Oncology
  • Surgical Oncology
  • Gastroenterology

Background:

  • Malignant peritoneal mesothelioma (MPM) is a rare and aggressive cancer.
  • MPM often presents with vague symptoms and ascites, with advanced disease confined to the peritoneum.

Purpose of the Study:

  • To review the role of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment and palliation of MPM.
  • To discuss prognostic factors influencing survival in MPM patients treated with CRS/HIPEC.

Main Methods:

  • Review of current literature on MPM treatment, focusing on CRS/HIPEC.
  • Analysis of prognostic factors affecting outcomes in MPM.

Main Results:

  • CRS/HIPEC is the established treatment for MPM, demonstrating a median overall survival of approximately 50 months.
  • Prognostic factors include age, gender, histology, peritoneal carcinomatosis index, comorbidities, nodal status, and completeness of cytoreduction.
  • Palliative HIPEC can resolve refractory malignant ascites and improve quality of life in unresectable cases.

Conclusions:

  • CRS/HIPEC is critical for both curative treatment and palliation of MPM.
  • Patient selection and achieving complete cytoreduction are key to optimal outcomes in MPM management.
Keywords:
cytoreductive surgeryhyperthermic intraperitoneal chemotherapymalignant peritoneal mesotheliomaperitoneal surface disease

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