ASO Author Reflections: Long-Term Survival Is Feasible After Complete CRS/HIPEC for Biphasic Peritoneal Mesothelioma

Our plain-English summary of ASO Author Reflections: Long-Term Survival Is Feasible After Complete CRS/HIPEC for Biphasic Peritoneal Mesothelioma, by K. Chouliaras, K.I. Votanopoulos (Annals of Surgical Oncology, 2018).

The study

• Authors: K. Chouliaras, K.I. Votanopoulos
• Journal: Annals of Surgical Oncology
• Published: 2018;25(Suppl 3):770-771
• Type of article: Comment
• Read it: PubMed · Publisher

In plain English

This is a short invited commentary, not a full research report. The two authors reflected on their earlier study of biphasic peritoneal mesothelioma using the Peritoneal Surface Oncology Group International Registry. The treatment discussed was cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC). The commentary did not discuss asbestos exposure. Of 1165 mesothelioma patients collected from 33 centers over 26 years, only 34 biphasic patients achieved a CC0 or CC1 surgery. CC0, CC1 and CC2 are the article's grades for how completely the tumor was removed. Median survival was reported as 6.8 years after CC0, 2.8 years after CC1 and 4.3 months after CC2 resection. CC status and the PCI score were the only predictors of survival. Only 13% of patients with a PCI score above 20 achieved a complete surgery. The authors noted that it is unknown how many patients had surgery attempted but aborted. They concluded that CRS/HIPEC at an experienced center should be a consideration for a sound surgical candidate diagnosed early, while complete surgery is still feasible. They also concluded that incomplete surgery should not be attempted.

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 author commentary (ASO Author Reflections) on the authors' own retrospective registry study
• Who was studied: 1165 mesothelioma patients collected from 33 centers over 26 years in the Peritoneal Surface Oncology Group International Registry, of whom 34 biphasic patients achieved CC0 or CC1 surgery
• Exposure: No asbestos exposure was studied. The treatment examined was cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) for biphasic peritoneal mesothelioma.
• Main results:
  • Median survival was 6.8 years after CC0 resection, 2.8 years after CC1 resection and 4.3 months after CC2 resection
  • CC status of resection and the PCI score were the only predictors of survival. The authors suggested this was probably because heavier disease burden makes complete surgery unlikely.
  • Only 13% of patients with a PCI score above 20 achieved a complete CRS. The comparison symbol is garbled in the text.
• The authors' conclusion: The authors concluded that, for a sound surgical candidate with biphasic mesothelioma diagnosed early while complete surgery is still feasible, CRS/HIPEC at an experienced center should be a consideration. They also concluded that incomplete surgery should not be attempted because it often leads to unnecessary morbidity without survival benefit.
• Limitations the authors state:
  • It is unknown how many patients had an attempted but aborted CRS/HIPEC, or why
  • The authors noted that the analysis was retrospective and that cohort analysis has limitations

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: HIPEC, Biphasic Mesothelioma, Peritoneal Mesothelioma.

Related studies

• Dose-Dependent Effect of Red Blood Cells Transfusion on Perioperative and Long-Term Outcomes in Peritoneal Surface Malignancies Treated with Cytoreduction and HIPEC — E. Nizri, S. Kusamura, et al. (2018)
• Is Cytoreductive Surgery with Hyperthermic Intraperitoneal Chemotherapy Justified for Biphasic Variants of Peritoneal Mesothelioma? Outcomes from the Peritoneal Surface Oncology Group International Registry — K.I. Votanopoulos, P. Sugarbaker, et al. (2018)
• Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) with cisplatin in pediatric patients with peritoneal mesothelioma: a single institution experience and long term follow up — P. Malekzadeh, M. Good, et al. (2021)
• Multicystic mesothelioma: Operative and long-term outcomes with cytoreductive surgery and hyperthermic intra peritoneal chemotherapy — E. Nizri, D. Baratti, et al. (2018)
• Long-term Survival and Propensity Score Matched Outcomes of Bilateral vs. Unilateral Diaphragm Interventions in Cytoreductive Surgery plus Intra-peritoneal Chemotherapy — B. Singh, G. Singh, et al. (2018)
• ASO Author Reflections: Improving Outcomes in Diffuse Malignant Peritoneal Mesothelioma: Challenges and Opportunities — J.C. Leinwand, M.D. Kluger (2020)

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