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Peritoneal Mesothelioma in a High Volume Peritoneal Surface Malignancies Unit

Fernando Pereira1,2, Mónica Pereira2, Israel Manzanedo1,2

  • 1Peritoneal Surface Malignancies Unit, Department of Surgery, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain.

Journal of Clinical Medicine
|March 29, 2023
PubMed

Insights

Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) offers prolonged survival for peritoneal mesothelioma (PM) patients. This treatment, when feasible, is optimal for PM management, improving patient outcomes.

Area of Science:

  • Oncology
  • Surgical Oncology
  • Gastroenterology

Background:

  • Peritoneal mesothelioma (PM) is a rare cancer with a historically poor prognosis.
  • Less common PM subtypes exist with uncertain malignancy.
  • Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) has shown promise for prolonged survival in select patients.

Purpose of the Study:

  • To analyze clinicopathological characteristics, diagnostic methods, and survival outcomes of peritoneal mesothelioma patients treated at our center.
  • To evaluate the effectiveness of different treatment modalities for various PM subtypes.

Main Methods:

  • Retrospective analysis of 17 peritoneal mesothelioma patients treated between 2007 and 2019.
  • Assessment of clinicopathological data, diagnostic procedures, and treatment responses.
  • Surgical interventions included complete cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC).

Main Results:

  • Multicystic PM treated with CRS + HIPEC showed complete disease-free survival.
  • Biphasic PM had limited survival (<6 months) with no curative treatment options.
  • Epithelioid PM treated with curative CRS + HIPEC achieved a median overall survival of 58 months (47.4% 5-year OS).
  • One unresectable epithelioid PM case had long survival (67 months) with palliative HIPEC for ascites.

Conclusions:

  • Cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) is the optimal treatment for eligible peritoneal mesothelioma (PM) patients.
  • Timely referral to specialized centers for CRS + HIPEC is crucial for improving PM patient outcomes.
  • Further research into managing unresectable and rare PM subtypes is warranted.
Keywords:
HIPECcytoreductive surgeryepithelioid subtypeperitoneal mesothelioma

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