Malignant peritoneal mesothelioma treated by continuous hyperthermic peritoneal perfusion chemotherapy

Our plain-English summary of Malignant peritoneal mesothelioma treated by continuous hyperthermic peritoneal perfusion chemotherapy, by E. de Bree, M. Christodoulakis, D. Tsiftsis (Annals of Oncology, 2000).

The study

• Authors: E. de Bree, M. Christodoulakis, D. Tsiftsis
• Journal: Annals of Oncology
• Published: 2000;11(6):753-6
• Type of article: Case report
• Cited by: 14 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Malignant mesothelioma of the peritoneum is a rare tumour for which the therapeutic approach has not yet been standardized. The efficacy of the current regimes is limited. Effective locoregional therapy is crucial, since this tumour is most often confined to the peritoneal cavity at the time of the initial diagnosis and remains there for much of its clinical course. If and when haematogenous metastases occur, they rarely contribute to the death of the patient, which is often caused by the overgrowth of the primary tumour and its local complications. A case of diffuse malignant peritoneal mesothelioma treated by cytoreductive surgery and continuous hyperthermic peritoneal perfusion with cisplatin is reported. The patient received systemic combination chemotherapy postoperatively. She is in good condition and free of disease 28 months after her treatment. Continuous hyperthermic peritoneal perfusion chemotherapy has recently been used in patients with secondary peritoneal carcinomatosis from digestive and gynecological malignancies with promising results. It is also possible that the same treatment alone or in combination with systemic chemotherapy may be effective in the treatment of primary peritoneal malignancies, as in the case of diffuse peritoneal mesothelioma.

In plain English

This article is a case report describing one patient treated at the Department of Surgical Oncology, University of Crete, Greece. A 76-year-old woman had an 18-month history of abdominal pain, nausea, change of bowel habit, swelling, and loss of appetite and weight. Ovarian cancer was first suspected, but a biopsy showed malignant epithelial peritoneal mesothelioma. The authors stated she had no obvious past exposure to asbestos. Surgeons removed visibly involved organs and drained six liters of fluid, but tumor nodules larger than 5 mm had to be left behind. Her abdomen was then perfused for 120 minutes with heated fluid containing cisplatin (90 mg per square meter). This treatment is called continuous hyperthermic peritoneal perfusion chemotherapy. Her recovery was uneventful, no systemic cisplatin toxicity was observed, and she remained free of abdominal fluid. She then received six courses of combination chemotherapy. At 28 months she was in good condition and clinically free of disease. The authors concluded that further clinical studies are needed to determine whether this combined treatment can improve quality of life and survival.

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: case report (single patient)
• Who was studied: One 76-year-old woman with diffuse malignant peritoneal mesothelioma (malignant epithelial type), referred to the Department of Surgical Oncology, University of Crete, Herakleion, Greece. Ovarian carcinoma had first been diagnosed clinically. Treatment dates are not given.
• Exposure: The article studied a treatment, not asbestos exposure, and stated the patient had no obvious past asbestos exposure. Treatment was cytoreductive surgery, then continuous hyperthermic peritoneal perfusion chemotherapy with cisplatin at 90 mg per square meter for 120 minutes, followed by systemic combination chemotherapy.
• Main results:
  • Surgery achieved only suboptimal cytoreduction: tumor nodules larger than 5 mm were left behind in this patient.
  • The patient's postoperative course was uneventful, with no systemic cisplatin toxicity observed.
  • After the operation the patient remained free of ascites (abdominal fluid). She then received six courses of carboplatin, paclitaxel, VP-16, ifosfamide and mesna.
  • The patient was in good condition and clinically free of disease 28 months after the perfusion treatment.
• The authors' conclusion: The authors concluded that further clinical studies are needed to determine whether cytoreductive surgery, continuous hyperthermic peritoneal perfusion chemotherapy and postoperative systemic chemotherapy together can improve quality of life and survival. They also suggested it is possible that this treatment may be effective for diffuse peritoneal mesothelioma.

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, Chemotherapy, Malignant Mesothelioma, Peritoneum, Peritoneal Cavity, Cytoreductive Surgery, Cisplatin.

Related studies

• Treatment of primary peritoneal mesothelioma by continuous hyperthermic peritoneal perfusion (CHPP) — B.J. Park, H.R. Alexander, et al. (1999)
• Multicystic peritoneal mesothelioma: outcomes and patho-biological features in a multi-institutional series treated by cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) — D. Baratti, M. Vaira, et al. (2010)
• Iterative procedures combining cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for isolated peritoneal recurrence — M. Vaira, M. Robella, et al. (2014)
• Utility of Chemoresponse Assay in Patients Undergoing Cytoreductive Surgery Plus Hyperthermic Intraperitoneal Chemotherapy — S. Bhagwandin, S. Naffouje, et al. (2015)
• The results of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in 1200 patients with peritoneal malignancy — B. Moran, T. Cecil, et al. (2015)
• Repeat cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for recurrent diffuse malignant peritoneal mesothelioma — Y. Huang, N.A. Alzahrani, et al. (2015)

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