ASO Author Reflections: Expert Surgical Evaluation is Critical for Patients with Diffuse Malignant Peritoneal Mesothelioma: Lessons Learned from Assessing Outcomes of 2000 Patients

Our plain-English summary of ASO Author Reflections: Expert Surgical Evaluation is Critical for Patients with Diffuse Malignant Peritoneal Mesothelioma: Lessons Learned from Assessing Outcomes of 2000 Patients, by L. Bijelic, T. Cannon (Annals of Surgical Oncology, 2020).

The study

• Authors: L. Bijelic, T. Cannon
• Journal: Annals of Surgical Oncology
• Published: 2020;27(8):2983-2984
• Read it: PubMed · Publisher

In plain English

This is a short invited commentary, not a full research report. The authors reflected on their own separate study of diffuse malignant peritoneal mesothelioma, a cancer of the abdominal lining, using the US National Cancer Database. That study, the commentary reports, analyzed 2062 patients; 34% had radical surgery and 51.2% had no surgery. Median overall survival for all patients was 15.6 months. Survival was 38.4 months after radical surgery, 32.4 months after limited surgery and 7.1 months after no surgery. Surgery was an independent factor for survival in the multivariable analysis. For patients given radical surgery with intraoperative chemotherapy (which the authors presumed to be HIPEC), median survival was 66.6 months without added systemic chemotherapy and 65.4 months with it (p = 0.964). The authors described this as little impact from the added chemotherapy. They concluded surgery can have a profound positive impact on survival for well-selected patients. They also said newly diagnosed patients should always be offered a multidisciplinary evaluation including input from a surgical oncologist with expertise in peritoneal surface malignancies. The commentary does not discuss asbestos.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Invited commentary (ASO Author Reflections) by the authors on their own separately published National Cancer Database analysis; not an original research report
• Who was studied: 2062 patients with diffuse malignant peritoneal mesothelioma across the United States, recorded in the National Cancer Database (years not stated in the commentary)
• Exposure: Treatments received: radical surgery, limited surgery or no surgery; intraoperative chemotherapy (presumed to be HIPEC); systemic chemotherapy. Asbestos exposure is not discussed.
• Main results:
  • 34% of the patients received radical surgery, and the majority (51.2%) received no surgical intervention
  • Median overall survival of all patients was 15.6 months
  • Survival was 38.4 months after radical surgery, 32.4 months after limited surgery and 7.1 months after no surgery
  • Surgery was an independent factor for survival in the multivariable analysis
  • Among patients with radical surgery and intraoperative chemotherapy, median overall survival was 66.6 months without additional systemic chemotherapy and 65.4 months with it (p = 0.964)
• The authors' conclusion: The authors concluded that a universally nihilistic approach is not justified and that surgery can have a profound positive impact on survival for well-selected patients. They said newly diagnosed patients should always be offered a true multidisciplinary evaluation that includes input from a surgical oncologist with expertise in peritoneal surface malignancies.
• Limitations the authors state:
  • The intraoperative chemotherapy recorded in the database was only presumed to be HIPEC

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma, Peritoneal mesothelioma.

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma.

Related studies

• ASO Author Reflections: Improving Outcomes in Diffuse Malignant Peritoneal Mesothelioma: Challenges and Opportunities — J.C. Leinwand, M.D. Kluger (2020)
• ASO Author Reflections: Long-Term Survival Is Feasible After Complete CRS/HIPEC for Biphasic Peritoneal Mesothelioma — K. Chouliaras, K.I. Votanopoulos (2018)
• ASO Author Reflections: Management of Malignant Peritoneal Mesothelioma — T.R. Cushman, V. Verma, et al. (2018)
• Unusually favorable outcome of 6 consecutive patients with diffuse malignant peritoneal mesothelioma treated with repeated doses of intraperitoneal paclitaxel. A case series — P.H. Sugarbaker, O.A. Stuart (2020)
• Iterative cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for recurrent or progressive diffuse malignant peritoneal mesothelioma: clinicopathologic characteristics and survival outcome — C. Ihemelandu, L. Bijelic, et al. (2015)
• Fifteen years in the evaluation of extrapleural pneumonectomy: Lessons to be learned — T. Treasure, F. Macbeth (2015)

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