Peritoneal mesothelioma in Sweden: A population-based study.

Area of Science:

• Oncology
• Surgical Oncology
• Cancer Epidemiology

Background:

• Peritoneal mesothelioma is a rare and aggressive cancer.
• Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is a specialized treatment approach.
• Understanding treatment outcomes and population-level trends is crucial for improving patient care.

Purpose of the Study:

• To report survival and morbidity outcomes for peritoneal mesothelioma patients treated with CRS and HIPEC in Sweden.
• To investigate if survival has improved on a population level since the nationalization of CRS/HIPEC treatment in 2011.
• To analyze trends in the incidence of diffuse malignant peritoneal mesothelioma (DMPM).

Main Methods:

• Data were collected from the Swedish HIPEC registry and the Swedish National Cancer Registry.
• Patients undergoing CRS/HIPEC between January 2011 and March 2018 were analyzed.
• Population-level analysis compared DMPM cases from 1999-2003 and 2011-2015.

Main Results:

• Thirty-two patients underwent CRS/HIPEC, with a 2-year survival rate of 84% (59% excluding borderline cases).
• Grade III-IV Clavien-Dindo events occurred in 22% of patients, with no treatment-related mortality.
• DMPM incidence increased from 0.9 to 1.24 per million/year (P=.04) between the two periods; median overall survival improved from 7 to 15 months (P=.03).

Conclusions:

• CRS/HIPEC offers good long-term survival for both borderline and diffuse malignant peritoneal mesothelioma.
• The incidence of DMPM in Sweden has significantly increased.
• Improved overall survival in Sweden correlates with the introduction of CRS/HIPEC, suggesting its potential contribution.