Prognostic factors influencing survival in 35 patients with malignant peritoneal mesothelioma

Abstract

Malignant mesothelioma is a rare but highly lethal form of cancer that affects the serosal membranes. Malignant peritoneal mesothelioma (MPM) is the second most common form of malignant mesothelioma (pleural mesothelioma is the most common). The aim of this study was to evaluate prognostic factors influencing the survival of patients with MPM.A retrospective analysis was performed on 35 patients who were admitted to our hospital between March 2005 and July 2013. The patients' demographic and clinical data, laboratory results, radiological signs, Eastern Cooperative Oncology Group (ECOG) performance status (PS), and treatment outcomes were evaluated.The mean age of the 35 patients was 59.0±14.4 years, the mean survival time was 16.2±12.9 months, and the majority of the histopathological types of MPM were epithelial (68.6%). 82.9% of the patients had been exposed to asbestos, and the mean duration of exposure was 28.3±14.5 years. The most frequent symptoms were abdominal distention/pain, weight loss, dyspnea, and chest pain. The mean interval between the onset of symptoms and the diagnosis was 4.6±3.3 months. Platinum-based combination chemotherapy in combination with supportive care was used in the treatment of 68.6% of the patients, while supportive treatment alone was used in the others. Our results revealed that patients who were >60 years old (p=0.019), who were exposed to asbestos >20 years (p=0.033), who had an ECOG PS of 3 (p=0.000) were more likely to have a poor MPM prognosis.In conclusion, increased age, duration of environmental asbestos exposure and ECOG PS are important factors that influence the prognosis of MPM patients.

Malignant peritoneal mesothelioma-A diagnostic and therapeutic challenge: A case report

“…Survival in malignant peritoneal mesothelioma ranges from 7 to 13.5 months [7]. Elabbakh et al [5] reported median survival of 12.5 months, while patients without chemotherapy had survival of 1 month only and those patients who undergone systemic chemotherapy had survival of 29 months [5].…”

“…Survival is favored for female gender, young age, epithelial type, absence of lymph node metastasis or extra abdominal metastasis, CC-0(complete cytoreduction-0) or CC-1, HIPEC treatment, lack of deep invasion, lower peritoneal carcinoma index, no history of previous debulking surgery and short exposure to asbestos [2,7,9]. our patient's most common symptoms and signs were bloating, abdominal pain, early satiety, weight loss, ascites, increased abdominal girth, abdominal mass, intestinal obstruction, and less commonly present: dyspnea, chest pain, dysphagia, or pleural effusion [5][6][7]. Diagnosis of malignant survival is consistent with those reported in the available literature except for the presence of lymph nodes.…”

Malignant peritoneal mesothelioma: a review

“…The most common initial complaint is abdominal distension, which is present in 30-80% of patients. Abdominal pain is the second most common symptom with 27-58% of patients presenting with this complaint (16)(17)(18)(19)(20)(21)(22). The pain is usually diffuse and nonspecific, though in rare instances the patient may present with an acute abdomen due to malignant bowel obstruction or perforation (23,24).…”

“…Complications related to the laparotomy and CRS include wound infections, prolonged ileus, bowel obstruction, fascial dehiscence, urinary tract infections, sepsis, and fistula formation. Without treatment, median survival has been reported from less than 5 months to up to 12 months from the time of diagnosis (16). Therefore, despite these known issues with CRS-HIPEC, the gains are substantial, with median survival rates of at least 38 months and up to 92 months.…”

The Effectiveness of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Patients with Malignant Peritoneal Mesothelioma: A Tertiary Center Experience

“…34 Researchers have reported that asbestos exposure has a negative effect on survival. 35 In our study, 18 patients (76.2%) had been exposed to asbestos. However, asbestos exposure did not seem to significantly influence survival in a univariate analysis.…”