Outcomes of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal mesothelioma: The Australian experience

Abstract

CRS and HIPEC is a treatment option for peritoneal mesothelioma. Patients with epithelioid tumor who undergo complete cytoreduction may potentially benefit from this procedure.

Prolonged response to pemetrexed-based chemotherapy in a patient with peritoneal mesothelioma: a case report and review of the literature

“…The diagnosis of epitheloid peritoneal mesothelioma was eventually made during explorative laparotomy. Initially, the patient was treated by HIPEC, an approach reported to provide the best long-term outcome [5][6][7], but in the present case the procedure was rather palliative due to advanced stage of the disease and failed to show any benefit. Because of subsequent rapid progression of ascites with a need of regular weekly paracentesis, the patient was treated with chemotherapy using the combination of cisplatin and pemetrexed.…”

“…Epitheloid histology has consistently been associated with a better prognosis [4], however, the prognosis is rather poor. Intensive multimodality approach comprising of cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (HIPEC) offers the best long-term outcome [5][6][7], but this treatment is feasible only in the minority of patients.…”

Malignant peritoneal mesothelioma: a review

“…The data for CRS-HIPEC for MPM has been largely based on single institution retrospective studies with two multiinstitution studies. The median overall survival ranged from 30 to 92 months (48,54,(57)(58)(59)(60)(61)(62). This wide range likely reflects surgeon variability, patient selection, and treatment modality, as there is no agreed-upon standardized technique for HIPEC.…”

“…Similar findings have been reported in multiple series for MPM as well. Yan et al [2009], Baratti et al [2013], and Schaub et al [2013] all demonstrated that the epithelioid subtype is a favorable prognostic factor for survival while those with sarcomatoid and biphasic subtypes have a worse prognosis (54,61,81,83). Schaub et al [2013] and Alexander et al [2013] both further sub-categorized the epithelioid subtype to include those with significant solid component as a marker for worse outcomes (57,81).…”

Evolution of management in peritoneal surface malignancies

“…Systemic chemotherapy and surgery showed limited benefit in this entity (56). Cytoreductive surgery with HIPEC showed a clear improvement in the outcome of DMPM as compared to traditional systemic chemotherapy (57)(58)(59)(60)(61)(62).…”