Cytoreductive surgery and HIPEC for malignant peritoneal mesothelioma: multi-institutional registry
Pooling eight centres, this registry showed that removing all visible peritoneal mesothelioma and washing the abdomen with heated chemotherapy gave a median survival of over four years, transforming the outlook for selected patients.
Overview
Retrospective multi-institutional registry of 405 patients with diffuse malignant peritoneal mesothelioma treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy at eight specialised centres.
Median overall survival was 53 months with three- and five-year survival of 60 and 47 percent; epithelioid histology, absence of nodal metastases, completeness of cytoreduction and use of HIPEC were independently associated with survival, while perioperative mortality was 2 percent.
- Median overall survival 53 months; five-year survival 47 percent.
- Completeness of cytoreduction and epithelioid subtype were the strongest prognostic factors.
Cytoreductive surgery with HIPEC in an experienced centre is the standard for fit patients with resectable epithelioid peritoneal mesothelioma, a disease that had a median survival of about a year on chemotherapy alone.
- Retrospective registry with selection of fit patients with resectable disease.
- No randomised comparison with systemic therapy exists.