Circulating CA125 in Patients with Peritoneal Mesothelioma Treated with Cytoreductive Surgery and Intraperitoneal Hyperthermic Perfusion

Baratti, Dario; Kusamura, Shigeki; Martinetti, Antonia; Seregni, Ettore; Oliva, Daniela G.; Laterza, Barbara; Deraco, Marcello

doi:10.1245/s10434-006-9192-8

Cited by 70 publications

(57 citation statements)

References 30 publications

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“…In the present case, since the tumor had already metastasized to the liver and abdominal lymph nodes at the time of diagnosis, we chose systemic chemotherapy (CDDP plus PEM) rather than a combination of cytoreductive surgery and intraperitoneal chemotherapy, but unfortunately it was ineffective. In fact, the serum levels of CA125 and hyaluronic acid, which were previously reported to be useful for monitoring the effectiveness of therapy, increased gradually during the clinical course after the introduction of systemic chemotherapy (14,15). SMRP was recently identified as a potential serum marker of malignant mesothelioma, and has also been shown to be useful for monitoring disease progression (16,17).…”

Section: Discussionmentioning

confidence: 99%

Primary Malignant Mesothelioma of the Appendix

et al. 2012

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We report a case of primary malignant mesothelioma of the appendix. A 35-year-old man without any history of asbestos exposure was admitted to our hospital for further examination following the discovery of multiple liver tumors, an ileocecal tumor, and abdominal lymph node swelling. An ultrasound-guided liver tumor biopsy revealed malignant mesothelioma. Despite receiving systemic chemotherapy, he died 3 months after the initial diagnosis. At autopsy, a diagnosis of multiple organ metastases from a malignant biphasic mesothelioma of the appendix was made. To our knowledge, this is only the second reported case of primary malignant mesothelioma of the appendix.

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Section: Discussionmentioning

confidence: 99%

Primary Malignant Mesothelioma of the Appendix

et al. 2012

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“…However, the role of serum tumour markers has been underlined. In patients with peritoneal mesothelioma, we reported a sensitivity rate of 100% (12/12) for CA125 in assessing disease progression after complete CRS and HIPEC [46] In patients with pseudomyxoma peritonei with positive baseline values, marker concentrations at progression were elevated in 24 of 29 (82.7%) patients for CEA, in 18 of 22 (81.8%) patients for CA19.9, in 12 of 19 (63.1%) patients for CA125, and in 4 of 6 (66.7%) patients for CA15.3 [47] . Van Ruth reported that CEA normalized in 73% patients and CA19.9 in 57% patients with preoperative increased levels, and that CA19.9 was positive in 14 of 14 cases of relapsing PMP with elevated preoperative levels [48] .…”

Section: Long Term Follow-upmentioning

confidence: 98%

Early and long-term postoperative management following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

Baratti¹,

Kusamura²,

Laterza³

et al. 2010

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Peritoneal surface malignancies have been traditionally regarded as end-stage conditions amenable to merely palliative options. The combination of aggressive cytoreductive surgery (CRS), involving peritonectomy procedures and multivisceral resections, with intraoperative hyperthermic intra-peritoneal chemotherapy (HIPEC) and/or early postoperative intra-peritoneal chemotherapy (EPIC) to treat the microscopic residual tumor is a new concept. In recent years, promising results have been reported for peritoneal mesothelioma and carcinomatosis of gastrointestinal and gynaecologic origin treated by this combined protocol. However, CRS with HIPEC and/or EPIC is a complex procedure associated with high rates of potentially life-threatening complications. Furthermore, disease progression following comprehensive treatment is not uncommon and represents a relevant cause of treatment failure. The present paper reviews the available information on early postoperative management and long-term follow-up in patients treated with CRS and intraperitoneal chemotherapy. The peculiar clinical and biological alterations that can be expected during an uncomplicated postoperative course, as compared to standard digestive surgery, are discussed. Early recognition and appropriate management of the most common adverse events are addressed, in order to minimize the impact of treatment-related morbidity on survival and quality of life results. Since re-operative surgery with additional HIPEC, has proven to be useful in selected patients with recurrent disease, long-term surveillance aiming at early detection of postoperative disease progression has become a relevant issue. Current results on follow-up investigations are presented.

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“…Most of the research on serum markers have been done in pleural mesothelioma, with some patients shown to have elevations in CA-125, alpha fetoprotein, CEA, mesothelin, osteopontin, and fibulin-3. Unfortunately, their sensitivities are too low to be used for diagnostic purposes (28,(33)(34)(35). Levels of serum mesothelinrelated protein (SRMP) have shown more promise, with a sensitivity of 60% (7,36).…”

Section: Diagnosismentioning

confidence: 99%

“…While not useful for diagnostic purposes in MPM, CA-125 and mesothelin have some promise for a marker of tumor response or surveillance. If initially elevated, serum CA-125 often normalizes to baseline levels after treatment and has been shown to correlate with post-treatment disease progression (33).…”

Section: Diagnosismentioning

confidence: 99%

Malignant peritoneal mesothelioma: a review

2017

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Mesothelioma is a malignancy of serosal membranes. It is most commonly encountered in the visceral pleura with the second most common location in the peritoneum. The diagnosis is very rare and has been linked to toxic exposure to industrial pollutants, especially asbestos. Malignant peritoneal mesothelioma (MPM) commonly presents with diffuse, extensive spread throughout the abdomen with rare metastatic spread beyond the abdominal cavity. Due to its rarity and nonspecific symptoms, it is usually diagnosed late when the disease burden is extensive. Because pleural mesothelioma is more common than MPM, most research has been on the pleural variant and extrapolated for MPM. While treatment advances have been made for MPM, the disease is universally fatal from either abdominal complications secondary to the spread of disease or starvation.Untreated, the life expectancy is less than a year. Cytoreductive surgery (CRS) with heated intraperitoneal chemotherapy (HIPEC) has become the mainstay of therapy with systemic therapies still being developed. We will review the epidemiology of MPM and discuss diagnostic and treatment strategies.

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Circulating CA125 in Patients with Peritoneal Mesothelioma Treated with Cytoreductive Surgery and Intraperitoneal Hyperthermic Perfusion

Abstract: CA125 was elevated in the majority of patients with PM in the present series. Serial maker measurements paralleled tumor growth or regression after CRS and IPHP, suggesting the need of further studies to assess the role of CA125 in this clinical setting.

Cited by 70 publications

References 30 publications

Primary Malignant Mesothelioma of the Appendix

Primary Malignant Mesothelioma of the Appendix

Early and long-term postoperative management following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

Malignant peritoneal mesothelioma: a review

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