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Long-term regional chemotherapy for patients with epithelial malignant peritoneal mesothelioma results in improved survival. [Review]

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Citation: European Journal of Surgical Oncology. 43(7):1228-1235, 2017 JulPMID: 28189456Institution: Washington Cancer InstituteForm of publication: Journal ArticleMedline article type(s): Journal Article | ReviewSubject headings: *Antineoplastic Combined Chemotherapy Protocols/ad [Administration & Dosage] | *Mesothelioma/dt [Drug Therapy] | *Peritoneal Neoplasms/dt [Drug Therapy] | Chemotherapy, Adjuvant/mt [Methods] | Cisplatin/ad [Administration & Dosage] | Cytoreduction Surgical Procedures | Doxorubicin/ad [Administration & Dosage] | Hyperthermia, Induced | Infusions, Parenteral | Mesothelioma/mo [Mortality] | Mesothelioma/pa [Pathology] | Mesothelioma/su [Surgery] | Paclitaxel/ad [Administration & Dosage] | Pemetrexed/ad [Administration & Dosage] | Perioperative Period | Peritoneal Neoplasms/mo [Mortality] | Peritoneal Neoplasms/pa [Pathology] | Peritoneal Neoplasms/su [Surgery] | Survival Rate | Time FactorsYear: 2017 Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library:2002-2007ISSN:

0748-7983

Name of journal: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical OncologyAbstract: CONCLUSIONS: Long-term regional chemotherapy was associated with improved survival in patients with MPM. In this rare disease, additional phase 2 investigations are suggested.Copyright � 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.METHODS: Cytoreductive surgery (CRS) is a series of peritonectomy procedures and visceral resections with a goal of complete removal of all visible disease from the abdomen and pelvis. Over 20 years, three protocols investigating increasing efficacy of additional chemotherapy treatments added to CRS have been initiated. Initially, hyperthermic perioperative chemotherapy (HIPEC) with doxorubicin and cisplatin was used in the operating room. Then, early postoperative intraperitoneal chemotherapy (EPIC) with paclitaxel was added for the first 5 days after CRS. The third protocol employed HIPEC, then EPIC, and then long-term intraperitoneal (IP) paclitaxel or IP pemetrexed plus intravenous (IV) cisplatin as a adjuvant normothermic intraperitoneal chemotherapy (NIPEC).PURPOSE: Malignant peritoneal mesothelioma (MPM) is a rare disease with about 300 new cases per year in the USA. Its natural history is described as local progression within the peritoneal space in the absence of liver metastases or systemic disease.RESULT: The 5-year survival of 42 patients treated with CRS and HIPEC was 44%, for 58 patients treated with EPIC and HIPEC was 52% and 29 patients who received HIPEC, EPIC, and NIPEC was 75% (p = 0.0374). Prognostic variables of age, gender, treatment administered, peritoneal cancer index (PCI) and completeness of cytoreduction were significant by univariate analysis and treatments administered and completeness of cytoreduction significant by multivariate analysis.All authors: Chang D, Sugarbaker PHFiscal year: FY2017Digital Object Identifier:

https://dx.doi.org/10.1016/j.ejso.2017.01.009

Date added to catalog: 2017-05-06

Holdings ( 1 )
Title notes ( 7 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	28189456	Available		28189456

Available online from MWHC library: 1995 - present, Available in print through MWHC library:2002-2007

CONCLUSIONS: Long-term regional chemotherapy was associated with improved survival in patients with MPM. In this rare disease, additional phase 2 investigations are suggested.

METHODS: Cytoreductive surgery (CRS) is a series of peritonectomy procedures and visceral resections with a goal of complete removal of all visible disease from the abdomen and pelvis. Over 20 years, three protocols investigating increasing efficacy of additional chemotherapy treatments added to CRS have been initiated. Initially, hyperthermic perioperative chemotherapy (HIPEC) with doxorubicin and cisplatin was used in the operating room. Then, early postoperative intraperitoneal chemotherapy (EPIC) with paclitaxel was added for the first 5 days after CRS. The third protocol employed HIPEC, then EPIC, and then long-term intraperitoneal (IP) paclitaxel or IP pemetrexed plus intravenous (IV) cisplatin as a adjuvant normothermic intraperitoneal chemotherapy (NIPEC).

PURPOSE: Malignant peritoneal mesothelioma (MPM) is a rare disease with about 300 new cases per year in the USA. Its natural history is described as local progression within the peritoneal space in the absence of liver metastases or systemic disease.

RESULT: The 5-year survival of 42 patients treated with CRS and HIPEC was 44%, for 58 patients treated with EPIC and HIPEC was 52% and 29 patients who received HIPEC, EPIC, and NIPEC was 75% (p = 0.0374). Prognostic variables of age, gender, treatment administered, peritoneal cancer index (PCI) and completeness of cytoreduction were significant by univariate analysis and treatments administered and completeness of cytoreduction significant by multivariate analysis.

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