Cytoreductive Surgery Plus HIPEC With and Without NIPEC for Malignant Peritoneal Mesothelioma: A Propensity-Matched Analysis. [Review]

MedStar author(s):
Citation: Annals of Surgical Oncology. 28(12):7109-7117, 2021 Nov.PMID: 33942167Institution: Washington Cancer InstituteForm of publication: Journal ArticleMedline article type(s): Journal Article | ReviewSubject headings: *Hyperthermia, Induced | *Mesothelioma | Antineoplastic Combined Chemotherapy Protocols/tu [Therapeutic Use] | Combined Modality Therapy | Cytoreduction Surgical Procedures | Humans | Hyperthermic Intraperitoneal Chemotherapy | Mesothelioma/th [Therapy] | Survival RateYear: 2021Local holdings: Available online from MWHC library: 1994 - presentISSN:
  • 1068-9265
Name of journal: Annals of surgical oncologyAbstract: BACKGROUND: Malignant peritoneal mesothelioma is a rare and often fatal disease. Dissemination is confined to the abdominal and pelvic peritoneal spaces in a great majority of patients.CONCLUSIONS: The addition of NIPEC was associated with long-term survival in this cohort of patients. A multi-institutional randomized trial may be the next step. Copyright © 2021. Society of Surgical Oncology.METHODS: Standardized cytoreductive surgery and perioperative chemotherapy was used in all patients. Long-term normothermic intraperitoneal chemotherapy (NIPEC) was added to the treatment of our most recent group of patients. Survival with and without NIPEC was compared using a propensity-matched analysis.RESULTS: In a uniform group of 74 patients, the clinical- and treatment-related features that had an impact on survival were age (hazard ratio [HR] 1.99, 95% confidence interval [CI] 0.929-4.238, p = 0.0766), completeness of cytoreduction (HR 2.356, 95% CI 1.113-4.989, p = 0.0251), and treatments administered (HR 3.497, 95% CI 1.199-10.20, p = 0.0219). In the Cox proportional hazards multivariant model, sex and age were borderline significant. Treatments administered were significant (HR 3.549, 95% CI 1.157-10.888, p = 0.0268). Using five features to match 29 patients in the control group (no NIPEC) to 29 patients in the experimental group (with NIPEC), the propensity-matched survival was significantly different (p = 0.0263).All authors: Chang D, Sugarbaker PHFiscal year: FY2022Digital Object Identifier: Date added to catalog: 2022-12-13
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 33942167 Available 33942167

Available online from MWHC library: 1994 - present

BACKGROUND: Malignant peritoneal mesothelioma is a rare and often fatal disease. Dissemination is confined to the abdominal and pelvic peritoneal spaces in a great majority of patients.

CONCLUSIONS: The addition of NIPEC was associated with long-term survival in this cohort of patients. A multi-institutional randomized trial may be the next step. Copyright © 2021. Society of Surgical Oncology.

METHODS: Standardized cytoreductive surgery and perioperative chemotherapy was used in all patients. Long-term normothermic intraperitoneal chemotherapy (NIPEC) was added to the treatment of our most recent group of patients. Survival with and without NIPEC was compared using a propensity-matched analysis.

RESULTS: In a uniform group of 74 patients, the clinical- and treatment-related features that had an impact on survival were age (hazard ratio [HR] 1.99, 95% confidence interval [CI] 0.929-4.238, p = 0.0766), completeness of cytoreduction (HR 2.356, 95% CI 1.113-4.989, p = 0.0251), and treatments administered (HR 3.497, 95% CI 1.199-10.20, p = 0.0219). In the Cox proportional hazards multivariant model, sex and age were borderline significant. Treatments administered were significant (HR 3.549, 95% CI 1.157-10.888, p = 0.0268). Using five features to match 29 patients in the control group (no NIPEC) to 29 patients in the experimental group (with NIPEC), the propensity-matched survival was significantly different (p = 0.0263).

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