Peritoneal papillary carcinoma

Our plain-English summary of Peritoneal papillary carcinoma, by S.B. Lele, M.S. Piver, J. Matharu, et al (Gynecologic Oncology, 1988).

The study

• Authors: S.B. Lele, M.S. Piver, J. Matharu, Y. Tsukada
• Journal: Gynecologic Oncology
• Published: 1988;31(2):315-20
• Type of article: Review
• Cited by: 60 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Between 1977 and 1986, 325 patients with a diagnosis of ovarian carcinoma, peritoneal cancer, or malignant mesothelioma were reviewed with identification of 23 patients (7%) having peritoneal papillary cancer. Only 2 patients had disease confined to the pelvis and the rest had widespread abdominal disease. Various combination chemotherapeutic agents were used with over a 65% response rate to first-line chemotherapy. Twenty of the 23 patients received cisplatin combination chemotherapy with an overall response rate of 65%.

In plain English

This was a retrospective review from Roswell Park Memorial Institute in Buffalo, New York. The authors reviewed the records of 325 patients referred between 1977 and 1986 with a diagnosis of ovarian carcinoma, peritoneal cancer, or malignant mesothelioma. They identified 23 (7%) with primary peritoneal papillary carcinoma. This tumor looks like serous papillary cancer of the ovary under the microscope but spares the ovaries or involves them only minimally. Cases that looked like mesothelioma were excluded, and the article does not discuss asbestos. Patients were aged 11 to 82 (median 63) and were treated with combination chemotherapy, most often cisplatin-based. The article reported 5 complete and 15 partial responses to first-line chemotherapy, an overall response of 65.1%, although its own Table 2 lists 10 partial responses. At the time of reporting, 6 patients were alive with no evidence of disease, 5 were alive with disease, and 12 had died. The authors concluded that these tumors appear responsive to cisplatin combination chemotherapy and suggested treating them like ovarian adenocarcinoma.

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: Retrospective review of patient records and pathology slides at a single cancer center
• Who was studied: 325 patients referred to Roswell Park Memorial Institute, Buffalo, New York, between 1977 and 1986 with ovarian carcinoma, peritoneal cancer, or malignant mesothelioma. Of these, 23 had primary peritoneal papillary carcinoma, aged 11 to 82 years (median 63).
• Exposure: No asbestos or fiber exposure is reported. The study concerns treatment with combination chemotherapy regimens (cisplatin-based combinations, methotrexate and cyclophosphamide regimens, intraperitoneal cisplatin). Cases with the histologic appearance of mesothelioma were excluded.
• Main results:
  • 23 of the 325 reviewed patients (7%) had primary peritoneal carcinoma
  • Among the 23 patients, first-line chemotherapy produced 5 complete (21.7%) and, as printed in the text, 15 partial (43.4%) responses
  • The overall response to first-line chemotherapy was 65.1%
  • 13 of the 15 responses were to cisplatin combination chemotherapy
  • Both patients with tumor confined to the pelvic cavity had complete responses
  • Six patients were alive with no evidence of disease 12 to 60 months after diagnosis
  • Twelve patients had died, with survival ranging from 2 to 96 months (median 8 months)
  • 14 of 23 patients had residual disease less than 2 cm when first-line chemotherapy began, and 12 of these 14 responded. Of the 9 patients with residual disease greater than 2 cm, 3 responded (2 complete, 1 partial).
  • The authors reported that tumor grade did not influence response or initial spread of disease
• The authors' conclusion: The authors concluded that, because these tumors look like ovarian adenocarcinoma and appear responsive to cisplatin combination chemotherapy, they should be treated similarly to ovarian adenocarcinoma and reported as peritoneal carcinomas.
• Limitations the authors state:
  • The authors note that their definition of the tumor was arbitrary
  • The authors note overlap with, and difficulty distinguishing this tumor from, small ovarian serous surface carcinoma
  • The authors note that distinguishing this tumor from diffuse mesothelioma can be difficult

Topics

Medical terms in this study, explained in our Lexicon: Carcinoma, Malignant Mesothelioma, Chemotherapy, Cisplatin.

Related studies

• Papillary tumors of the peritoneum in women: mesothelioma or papillary carcinoma — M. Kannerstein, J. Churg, et al. (1977)
• Primary papillary serous neoplasia of the peritoneum: a clinicopathologic and ultrastructural study of eight cases — U. Raju, G. Fine, et al. (1989)
• Benign papillary mesothelioma of the peritoneum: a consideration in the differential diagnosis of peritoneal implants — G. Tzanakakis, K.S. McCully, et al. (1989)
• Well-differentiated papillary mesothelioma of the peritoneum: a pathological analysis and review of the literature — A.V. Hoekstra, M.W. Riben, et al. (2005)
• Intraperitoneal chemotherapy for peritoneal surface malignancy: experience with 1,000 patients — E.A. Levine, J.H. Stewart, et al. (2014)
• Value of mesothelial and epithelial antibodies in distinguishing diffuse peritoneal mesothelioma in females from serous papillary carcinoma of the ovary and peritoneum — R.L. Attanoos, R. Webb, et al. (2002)

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