TY - JOUR
T1 - Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for malignant peritoneal mesothelioma
T2 - Multi-institutional experience
AU - Yan, Tristan D.
AU - Deraco, Marcello
AU - Baratti, Dario
AU - Kusamura, Shigeki
AU - Elias, Dominique
AU - Glehen, Olivier
AU - Gilly, François N.
AU - Levine, Edward A.
AU - Shen, Perry
AU - Mohamed, Faheez
AU - Moran, Brendan J.
AU - Morris, David L.
AU - Chua, Terence C.
AU - Piso, Pompiliu
AU - Sugarbaker, Paul H.
PY - 2009/12/20
Y1 - 2009/12/20
N2 - Purpose: This multi-institutional registry study evaluated cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) for diffuse malignant peritoneal mesothelioma (DMPM). Patients and Methods: A multi-institutional data registry that included 405 patients with DMPM treated by a uniform approach that used CRS and HIPEC was established. The primary end point was overall survival. The secondary end point was evaluation of prognostic variables for overall survival. Results: Follow-up was complete in 401 patients (99%). The median follow-up period for the patients who were alive was 33 months (range, 1 to 235 months). The mean age was 50 years (standard deviation [SD], 14 years). Three hundred eighteen patients (79%) had epithelial tumors. Twenty-five patients (6%) had positive lymph nodes. The mean peritoneal cancer index was 20. One hundred eighty-seven patients (46%) had complete or near-complete cytoreduction. Three hundred seventy-two patients (92%) received HIPEC. One hundred twenty-seven patients (31%) had grades 3 to 4 complications. Nine patients (2%) died perioperatively. The mean length of hospital stay was 22 days (SD, 15 days). The overall median survival was 53 months (1 to 235 months), and 3- and 5-year survival rates were 60% and 47%, respectively. Four prognostic factors were independently associated with improved survival in the multivariate analysis: epithelial subtype (P <.001), absence of lymph node metastasis (P <.001), completeness of cytoreduction scores of CC-0 or CC-1 (P <.001), and HIPEC (P = .002). Conclusion: The data suggest that CRS combined with HIPEC achieved prolonged survival in selected patients with DMPM.
AB - Purpose: This multi-institutional registry study evaluated cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) for diffuse malignant peritoneal mesothelioma (DMPM). Patients and Methods: A multi-institutional data registry that included 405 patients with DMPM treated by a uniform approach that used CRS and HIPEC was established. The primary end point was overall survival. The secondary end point was evaluation of prognostic variables for overall survival. Results: Follow-up was complete in 401 patients (99%). The median follow-up period for the patients who were alive was 33 months (range, 1 to 235 months). The mean age was 50 years (standard deviation [SD], 14 years). Three hundred eighteen patients (79%) had epithelial tumors. Twenty-five patients (6%) had positive lymph nodes. The mean peritoneal cancer index was 20. One hundred eighty-seven patients (46%) had complete or near-complete cytoreduction. Three hundred seventy-two patients (92%) received HIPEC. One hundred twenty-seven patients (31%) had grades 3 to 4 complications. Nine patients (2%) died perioperatively. The mean length of hospital stay was 22 days (SD, 15 days). The overall median survival was 53 months (1 to 235 months), and 3- and 5-year survival rates were 60% and 47%, respectively. Four prognostic factors were independently associated with improved survival in the multivariate analysis: epithelial subtype (P <.001), absence of lymph node metastasis (P <.001), completeness of cytoreduction scores of CC-0 or CC-1 (P <.001), and HIPEC (P = .002). Conclusion: The data suggest that CRS combined with HIPEC achieved prolonged survival in selected patients with DMPM.
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U2 - 10.1200/JCO.2009.23.9640
DO - 10.1200/JCO.2009.23.9640
M3 - Article
C2 - 19917862
AN - SCOPUS:74949123203
VL - 27
SP - 6237
EP - 6242
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
SN - 0732-183X
IS - 36
ER -