ASO Author Reflections: Improving Outcomes in Diffuse Malignant Peritoneal Mesothelioma: Challenges and Opportunities

Our plain-English summary of ASO Author Reflections: Improving Outcomes in Diffuse Malignant Peritoneal Mesothelioma: Challenges and Opportunities, by J.C. Leinwand, M.D. Kluger (Annals of Surgical Oncology, 2020).

The study

• Authors: J.C. Leinwand, M.D. Kluger
• Journal: Annals of Surgical Oncology
• Published: 2020;27(Suppl 3):742-743
• Read it: PubMed · Publisher

In plain English

This two-page piece is an invited commentary in which the authors reflected on their own earlier study of diffuse malignant peritoneal mesothelioma (DMPM), a cancer of the abdominal lining. It is not a full research report. That study looked at an intent-to-treat series of 204 DMPM patients from a single institution. The plan was two operations combining cytoreductive surgery with heated intraperitoneal chemotherapy (CRS/HIPEC), with 'dwell' chemotherapy in the abdomen between them, though not every patient received it. The authors reported median overall survival of 32 months from the first surgery, similar to other CRS/HIPEC series. Female sex, epithelioid disease and age were independent predictors of survival. The symbol showing which side of age 60 is garbled. For patients who did not receive dwell chemotherapy, the hazard ratio was 3.10, which the authors called a large effect. No confidence interval was given. The authors concluded that the combined protocol is a feasible approach and that DMPM patients may benefit from expanded access to curative-intent treatment. They noted that DMPM is rare and varied, which hinders clinical trials. 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 previously published single-institution intent-to-treat case series
• Who was studied: 204 patients with diffuse malignant peritoneal mesothelioma treated at a single institution. The commentary does not name the institution or give the study years.
• Exposure: No asbestos exposure is discussed. The study examined a treatment: two planned CRS/HIPEC operations with serial dwell intraperitoneal chemotherapy between them. Some patients did not receive the dwell chemotherapy.
• Main results:
  • Median overall survival among the 204 patients was 32 months from the initial cytoreduction. The authors described this as similar to other CRS/HIPEC series and an improvement over historical controls who received systemic chemotherapy alone.
  • Female sex, age (60-year cutoff) and epithelioid disease were independent baseline predictors of survival. The comparison symbol for age is garbled in the text, so it cannot be read which side of 60 it refers to.
  • Dwell intraperitoneal chemotherapy was independently associated with overall survival. The hazard ratio was 3.10 for patients who did not receive it, and no confidence interval was reported.
• The authors' conclusion: The authors concluded that CRS/HIPEC plus dwell intraperitoneal chemotherapy is a feasible approach for DMPM and that DMPM patients may benefit from expanded access to curative-intent treatment.
• Limitations the authors state:
  • The authors noted that DMPM is rare and heterogeneous, which hinders clinical trials.

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: Expert Surgical Evaluation is Critical for Patients with Diffuse Malignant Peritoneal Mesothelioma: Lessons Learned from Assessing Outcomes of 2000 Patients — L. Bijelic, T. Cannon (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)
• 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)
• 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)
• Two-Stage Cytoreductive Surgery and Intraperitoneal Chemotherapy for Diffuse Malignant Peritoneal Mesothelioma: Predictors of Overall Survival in an Intention-to-Treat Series — J.C. Leinwand, R.N. Taub, et al. (2020)

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