Australian Study Shows Treatment Advances for Peritoneal Mesothelioma

Patients with peritoneal mesothelioma undergoing a second cytoreductive surgery had a median survival of 92 months, according to a recent study at St. George Hospital and the University of South Wales in Sydney, Australia. That same group of patients also had a five-year survival rate of 71.8%, further illustrating the progress being made in treating the peritoneal subtype of this rare and aggressive cancer. The Journal of Surgical Oncology published the study in July 2019. The single-center study detailed the survival benefits of cytoreduction and perioperative intraperitoneal chemotherapy in colorectal, ovarian, appendiceal and mesothelioma cancers. It involved 1,225 patients, including 101 peritoneal mesothelioma cases, from 1996 through 2018. Peritoneal metastasis, which is the seeding of tumor cells on the peritoneal lining, was involved in all of the cancers in the study, prompting the similar type of treatment. “Once faced with skepticism due to its inherent morbidity, CRS/PIC [cytoreductive surgery and perioperative intraperitoneal chemotherapy] are becoming the standard of care,” the authors wrote. “The present large-cohort data highlights that CRS/PIC are effective and safe in providing long-term survival benefit.” PIC involves either hyperthermic intraperitoneal chemotherapy — also known as HIPEC — used intraoperatively, or early postoperative intraperitoneal chemotherapy, or both. The cytoreduction is an extensive debulking sur...
Source: Asbestos and Mesothelioma News - Category: Environmental Health Authors: Source Type: news

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Abstract The multimodal treatment of limited peritoneal metastases may improve prognosis in selected patients (pseudomyxoma peritonei, malignant peritoneal mesothelioma, colorectal, gastric and ovarian cancer) provided complete cytoreduction can be performed. Additive intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) is often performed. If the treatment is undertaken in experienced (and certified) centres, associated mortality is low. Intrapleural hyperthermic chemoperfusion (HITOC) can be performed in patients with pleural malignancies, mainly for malignant pleural mesothelioma or metastases from a...
Source: Zentralblatt fur Chirurgie - Category: Surgery Authors: Tags: Zentralbl Chir Source Type: research
ConclusionsOxaliplatin-based PIPAC appears to be a safe treatment that offers good symptom control and promising survival for patients with advanced peritoneal disease.
Source: European Journal of Surgical Oncology (EJSO) - Category: Surgery Source Type: research
ConclusionSurvivals beyond 20 months can be obtained with the use of CRS/HIPEC for rare PC etiologies aligning with results of other groups. CRS/HIPEC in well-selected patients demonstrates a clinical benefit and this could be confirmed with a multi-institutional study.
Source: The American Journal of Surgery - Category: Surgery Source Type: research
CONCLUSIONS: The risks of perioperative morbidity and mortality after CRS and HIPEC are analogous to any other major gastrointestinal surgery. CRS and HIPEC should remain a treatment option for highly selected patients in whom a curative or life prolonging treatment is a pursuit and should be performed in high volume specialized institutions. PMID: 29589675 [PubMed - as supplied by publisher]
Source: Minerva Chirurgica - Category: Surgery Tags: Minerva Chir Source Type: research
Conclusion For patients with rare tumors, CRS and HIPEC is feasible with an acceptable perioperative morbidity and mortality. To improve knowledge in patient selection and outcome, rare tumors treated with CRS and HIPEC should be documented in central databases (as for example BIG RENAPE, Pierre-Benite, France).
Source: Annals of Medicine and Surgery - Category: General Medicine Source Type: research
Authors: Tan G, Chia C, Kumar M, Choo SP, Chia J, Tham CK, Soo KC, Teo M Abstract INTRODUCTION: Peritoneal carcinomatosis (PC) is increasingly being treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). We provide a review of a high-volume Asian institute's experience and survival outcomes with this procedure. METHODS: Data was prospectively collected from 201 consecutive CRS and HIPEC procedures performed in a single institution between April 2001 and November 2015. Our primary endpoints were OS and DFS, and secondary endpoints were morbidity and mortality. RESULTS...
Source: International Journal of Hyperthermia - Category: Internal Medicine Tags: Int J Hyperthermia Source Type: research
ConclusionsOur study shows that good results may be achieved in terms of symptom palliation and improvement of quality of life in very advanced cancer patients with MA from PC. The treatment was generally well tolerated considering the limited treatment options available for these patients.
Source: Supportive Care in Cancer - Category: Cancer & Oncology Source Type: research
Authors: Spiliotis J, Halkia E, de Bree E Abstract Peritoneal carcinomatosis (ptc) represents advanced malignant disease and has generally been associated with a grim prognosis. Peritoneal surface malignancy is often the major source of morbidity and mortality; it is of major concern in cancer management. Although ptc is categorized as metastatic disease, it represents a special disease pattern considered to be a locoregional disease limited to the abdominal cavity. The combination of cytoreductive surgery (crs) and intraoperative hyperthermic intraperitoneal chemotherapy (hipec) has successfully been used as locor...
Source: Current Oncology - Category: Cancer & Oncology Tags: Curr Oncol Source Type: research
ObjectiveTo review our 25‐year experience with hyperthermic intra‐peritoneal chemotherapy (HIPEC). BackgroundCombining cytoreductive surgery (CRS) and HIPEC as local treatments for peritoneal carcinomatosis (PC) was proposed 25 years ago. MethodsA prospective database of all patients undergoing HIPEC for PC since 1989 was searched for clinicopathological data, 90‐day morbidity and mortality, and survival. ResultsAmong 1,125 HIPEC procedures, PC origin was colorectal (342; 30%), ovarian (271; 24%), pseudomyxoma peritonei (189; 17%), gastric (127; 11%), malignant mesothelioma (84; 8%), or other (112; 10%). Between 2004...
Source: Journal of Surgical Oncology - Category: Cancer & Oncology Authors: Tags: Research Article Source Type: research
Conclusion The decision to perform CCRS plus HIPEC for PC arising from unusual cancer origins remains difficult. These patients should be prospectively entered into registries of rare tumors that involve the peritoneum in order to better define indications.
Source: Journal of Visceral Surgery - Category: Surgery Source Type: research
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