Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Malignant Peritoneal Mesothelioma

Our plain-English summary of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Malignant Peritoneal Mesothelioma, by M.C. Russell, C.A. Staley (Journal of Oncology Practice, 2016).

The study

• Authors: M.C. Russell, C.A. Staley
• Journal: Journal of Oncology Practice
• Published: 2016;12(10):938-939
• Type of article: Comment
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This was a short commentary by two physicians at Emory University's Winship Cancer Institute. It discussed a review by Sugarbaker and colleagues, published in the same issue, about treating malignant peritoneal mesothelioma (mesothelioma of the lining of the abdomen) with cytoreductive surgery (CRS) and heated chemotherapy delivered into the abdomen (HIPEC). It reported no new patient data and did not discuss asbestos or any other cause of the disease. Drawing on published studies, the authors wrote that CRS and HIPEC are widely accepted as the standard of care. They added that only the epithelial tumor type has a favorable prognosis and that completeness of the surgery plays a major role in prognosis. They cited approximate surgical mortality of 2% to 4% and morbidity (complications) approaching 30% to 40%. A 405-patient review from 29 centers had reported median overall survival of 53 months, but centers differed widely in drugs and techniques. There were no standards for perfusion temperature or length, and no clinical trials in peritoneal mesothelioma. The authors concluded that standardized treatment based on well-conducted clinical trials is critical.

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: Commentary on a review article (Sugarbaker et al.) in the same journal issue; no original data
• Who was studied: No patients were studied. The commentary discusses published reports on patients with malignant peritoneal mesothelioma treated with CRS and HIPEC.
• Main results:
  • The authors stated, in agreement with the Sugarbaker et al. report, that CRS and HIPEC are widely accepted as the standards of care for peritoneal mesothelioma.
  • The authors stated that only the epithelial type has a favorable prognosis. Sarcomatoid and biphasic types generally do not fare well enough to warrant CRS and HIPEC.
  • Citing other studies, the authors gave approximate mortality from the surgery of 2% to 4%, with morbidity approaching 30% to 40%.
  • The authors described one of the largest multi-institutional reviews, of 405 patients from 29 centers worldwide, which reported a median actuarial overall survival of 53 months. They said comparisons across centers are difficult because of differences among sites.
  • The authors noted there are no standards for temperature during perfusion, length of perfusion, or degree of agitation.
  • The authors stated there were no clinical trials in peritoneal mesothelioma.
• The authors' conclusion: The authors argued that standardization of treatment based on well-conducted clinical trials is critical to defining the best treatment of the disease.

Topics

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

Related studies

• Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for malignant peritoneal mesothelioma: a systematic review and meta-analysis — J.H. Helm, J.T. Miura, et al. (2015)
• The Role of Ki-67 and Pre-cytoreduction Parameters in Selecting Diffuse Malignant Peritoneal Mesothelioma (DMPM) Patients for Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) — S. Kusamura, P.A. Torres Mesa, et al. (2016)
• 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)
• Conversion to Complete Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Malignant Peritoneal Mesothelioma After Bidirectional Chemotherapy — F. Le Roy, M. Gelli, et al. (2017)
• Iterative procedures combining cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for isolated peritoneal recurrence — M. Vaira, M. Robella, et al. (2014)
• 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)

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