Treatment of diffuse malignant peritoneal mesothelioma (DMPM) by cytoreductive surgery and HIPEC

M. Robella, M. Vaira, A. Mellano, P. Marsanic, A. Cinquegrana, A. Borsano, M. Barbera, A. Caneparo, D. Siatis, A. Sottile, M. De Simone

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Aim. Diffuse malignant peritoneal mesothelioma (DMPM) is a rare and locally aggressive tumor with poor prognosis, related in most cases to asbestos exposure. It is increasing in frequency, but currently no standard therapy is available. The biology of this disease is still poorly understood. Several highly specialized centers have recently reported improved survival by means of an innovative local-re- gional approach. The purpose of this article is to evaluate the survival benefit and the morbidity rate of patients affected by DMPM treated at our institution by cytoreductive surgery (CRS) associated with hyperthermic intraperitoneal perioperative chemotherapy (HIPEC). Methods. This study includes 42 patients affected by DMPM treated by an uniform approach consisting of cytoreductive surgery associated with HIPEC using cisplatin and doxorubicin. The primary end point was overall survival and morbidity rate. The secondary end point was evaluation of prognostic variables for overall survival. Results. The median follow-up period was 72 months (range 1-235 months). Thirty-five patients (83.3%) presented epithelial tumors and 7 were affected by multicystic mesothelioma. The mean peritoneal cancer index (PCI) was 13. Thirty-eight patients (90.4%) had complete cytoreduction (CC-0/1). The overall morbidity rate was 35.7% associated to a perioperative mortality of 7.1%. Median overall survival rate was 65 months with a 1- And 5-year survival rates of 63% and 44%, respectively. Conclusion. The treatment of DMPM by CRS+HIPEC in selected patients is a feasible technique that allows to achieve encouraging results in terms of overall survival rate, with an acceptable morbidity rate. Further investigations are needed to clarify the role and the timing of this promising technique.

Original languageEnglish
Pages (from-to)9-15
Number of pages7
JournalMinerva Chirurgica
Volume69
Issue number1
Publication statusPublished - 2014

Fingerprint

Drug Therapy
Survival Rate
Morbidity
Survival
Therapeutics
Neoplasms
Asbestos
Mesothelioma
Doxorubicin
Cisplatin
Malignant Mesothelioma
Mortality

Keywords

  • Asbestos
  • Carcinoma
  • Fever
  • Mesothelioma

ASJC Scopus subject areas

  • Surgery

Cite this

Treatment of diffuse malignant peritoneal mesothelioma (DMPM) by cytoreductive surgery and HIPEC. / Robella, M.; Vaira, M.; Mellano, A.; Marsanic, P.; Cinquegrana, A.; Borsano, A.; Barbera, M.; Caneparo, A.; Siatis, D.; Sottile, A.; De Simone, M.

In: Minerva Chirurgica, Vol. 69, No. 1, 2014, p. 9-15.

Research output: Contribution to journalArticle

@article{a66a75f1487d49d08e2b5fd6dd44c03e,
title = "Treatment of diffuse malignant peritoneal mesothelioma (DMPM) by cytoreductive surgery and HIPEC",
abstract = "Aim. Diffuse malignant peritoneal mesothelioma (DMPM) is a rare and locally aggressive tumor with poor prognosis, related in most cases to asbestos exposure. It is increasing in frequency, but currently no standard therapy is available. The biology of this disease is still poorly understood. Several highly specialized centers have recently reported improved survival by means of an innovative local-re- gional approach. The purpose of this article is to evaluate the survival benefit and the morbidity rate of patients affected by DMPM treated at our institution by cytoreductive surgery (CRS) associated with hyperthermic intraperitoneal perioperative chemotherapy (HIPEC). Methods. This study includes 42 patients affected by DMPM treated by an uniform approach consisting of cytoreductive surgery associated with HIPEC using cisplatin and doxorubicin. The primary end point was overall survival and morbidity rate. The secondary end point was evaluation of prognostic variables for overall survival. Results. The median follow-up period was 72 months (range 1-235 months). Thirty-five patients (83.3{\%}) presented epithelial tumors and 7 were affected by multicystic mesothelioma. The mean peritoneal cancer index (PCI) was 13. Thirty-eight patients (90.4{\%}) had complete cytoreduction (CC-0/1). The overall morbidity rate was 35.7{\%} associated to a perioperative mortality of 7.1{\%}. Median overall survival rate was 65 months with a 1- And 5-year survival rates of 63{\%} and 44{\%}, respectively. Conclusion. The treatment of DMPM by CRS+HIPEC in selected patients is a feasible technique that allows to achieve encouraging results in terms of overall survival rate, with an acceptable morbidity rate. Further investigations are needed to clarify the role and the timing of this promising technique.",
keywords = "Asbestos, Carcinoma, Fever, Mesothelioma",
author = "M. Robella and M. Vaira and A. Mellano and P. Marsanic and A. Cinquegrana and A. Borsano and M. Barbera and A. Caneparo and D. Siatis and A. Sottile and {De Simone}, M.",
year = "2014",
language = "English",
volume = "69",
pages = "9--15",
journal = "Minerva Chirurgica",
issn = "0026-4733",
publisher = "Edizioni Minerva Medica S.p.A.",
number = "1",

}

TY - JOUR

T1 - Treatment of diffuse malignant peritoneal mesothelioma (DMPM) by cytoreductive surgery and HIPEC

AU - Robella, M.

AU - Vaira, M.

AU - Mellano, A.

AU - Marsanic, P.

AU - Cinquegrana, A.

AU - Borsano, A.

AU - Barbera, M.

AU - Caneparo, A.

AU - Siatis, D.

AU - Sottile, A.

AU - De Simone, M.

PY - 2014

Y1 - 2014

N2 - Aim. Diffuse malignant peritoneal mesothelioma (DMPM) is a rare and locally aggressive tumor with poor prognosis, related in most cases to asbestos exposure. It is increasing in frequency, but currently no standard therapy is available. The biology of this disease is still poorly understood. Several highly specialized centers have recently reported improved survival by means of an innovative local-re- gional approach. The purpose of this article is to evaluate the survival benefit and the morbidity rate of patients affected by DMPM treated at our institution by cytoreductive surgery (CRS) associated with hyperthermic intraperitoneal perioperative chemotherapy (HIPEC). Methods. This study includes 42 patients affected by DMPM treated by an uniform approach consisting of cytoreductive surgery associated with HIPEC using cisplatin and doxorubicin. The primary end point was overall survival and morbidity rate. The secondary end point was evaluation of prognostic variables for overall survival. Results. The median follow-up period was 72 months (range 1-235 months). Thirty-five patients (83.3%) presented epithelial tumors and 7 were affected by multicystic mesothelioma. The mean peritoneal cancer index (PCI) was 13. Thirty-eight patients (90.4%) had complete cytoreduction (CC-0/1). The overall morbidity rate was 35.7% associated to a perioperative mortality of 7.1%. Median overall survival rate was 65 months with a 1- And 5-year survival rates of 63% and 44%, respectively. Conclusion. The treatment of DMPM by CRS+HIPEC in selected patients is a feasible technique that allows to achieve encouraging results in terms of overall survival rate, with an acceptable morbidity rate. Further investigations are needed to clarify the role and the timing of this promising technique.

AB - Aim. Diffuse malignant peritoneal mesothelioma (DMPM) is a rare and locally aggressive tumor with poor prognosis, related in most cases to asbestos exposure. It is increasing in frequency, but currently no standard therapy is available. The biology of this disease is still poorly understood. Several highly specialized centers have recently reported improved survival by means of an innovative local-re- gional approach. The purpose of this article is to evaluate the survival benefit and the morbidity rate of patients affected by DMPM treated at our institution by cytoreductive surgery (CRS) associated with hyperthermic intraperitoneal perioperative chemotherapy (HIPEC). Methods. This study includes 42 patients affected by DMPM treated by an uniform approach consisting of cytoreductive surgery associated with HIPEC using cisplatin and doxorubicin. The primary end point was overall survival and morbidity rate. The secondary end point was evaluation of prognostic variables for overall survival. Results. The median follow-up period was 72 months (range 1-235 months). Thirty-five patients (83.3%) presented epithelial tumors and 7 were affected by multicystic mesothelioma. The mean peritoneal cancer index (PCI) was 13. Thirty-eight patients (90.4%) had complete cytoreduction (CC-0/1). The overall morbidity rate was 35.7% associated to a perioperative mortality of 7.1%. Median overall survival rate was 65 months with a 1- And 5-year survival rates of 63% and 44%, respectively. Conclusion. The treatment of DMPM by CRS+HIPEC in selected patients is a feasible technique that allows to achieve encouraging results in terms of overall survival rate, with an acceptable morbidity rate. Further investigations are needed to clarify the role and the timing of this promising technique.

KW - Asbestos

KW - Carcinoma

KW - Fever

KW - Mesothelioma

UR - http://www.scopus.com/inward/record.url?scp=84899701677&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84899701677&partnerID=8YFLogxK

M3 - Article

C2 - 24675242

AN - SCOPUS:84899701677

VL - 69

SP - 9

EP - 15

JO - Minerva Chirurgica

JF - Minerva Chirurgica

SN - 0026-4733

IS - 1

ER -