000			04041nam a22006737a 4500
008			160204s20152015 xxu||||| |||| 00| 0 eng d
022			_a1068-9265
040			_aOvid MEDLINE(R)
099			_a25120250
245			_aIterative cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for recurrent or progressive diffuse malignant peritoneal mesothelioma: clinicopathologic characteristics and survival outcome.
251			_aAnnals of Surgical Oncology. 22(5):1680-5, 2015 May.
252			_aAnn Surg Oncol. 22(5):1680-5, 2015 May.
253			_aAnnals of surgical oncology
260			_c2015
260			_fFY2015
266			_d2016-05-24
501			_aAvailable online from MWHC library: 1994 - present
520			_aBACKGROUND: Diffuse malignant peritoneal mesothelioma (DMPM) is an aggressive disease for which cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have been used with remarkable survival benefits. Our aim was to analyze the clinicopathologic characteristics and prognosis of recurrent DMPM managed with iterative CRS and HIPEC.
520			_aCONCLUSION: Iterative CRS and HIPEC can be performed safely and appear to have benefits with this group of patients showing an improved median survival.
520			_aMETHODS: A retrospective analysis of a prospectively maintained database for all patients treated for DMPM from 1989 to 2012.
520			_aRESULTS: Of 205 consecutive CRS and HIPEC procedures, 44 (21.5 %) patients underwent an iterative procedure-22 (50.0 %) males versus 22 (50.0 %) females. Mean age at recurrence was 51.5 years. There was no 30-day mortality following an iterative procedure, and the grade III-V morbidity was 2.3 %. The median overall survival of patients undergoing an iterative CRS and HIPEC was 54 months versus 77 months following an initial CRS and HIPEC (p = 0.96). Patients undergoing an iterative surgery had a 3- and 5-year survival of 61 and 46 %, respectively, versus 60 and 52 % following an initial CRS and HIPEC. Amongst the iterative group, the achieved complete cytoreduction (CC) score was 15.9, 18.2, 22.7, and 43.2 % for CC0, CC1, CC2 and CC3, respectively, versus 3.1, 43.5, 28.6 and 24.8 %, respectively, following initial CRS (p = 0.000). Significant predictors of an improved survival in multivariate analysis were an epithelioid subtype, female sex, complete or near CC (CC0 or CC1), HIPEC regimen utilized, absence of postoperative complication, and age at diagnosis.
546			_aEnglish
650			_a*Antineoplastic Combined Chemotherapy Protocols/tu [Therapeutic Use]
650			_a*Chemotherapy, Cancer, Regional Perfusion/mo [Mortality]
650			_a*Cytoreduction Surgical Procedures/mo [Mortality]
650			_a*Hyperthermia, Induced/mo [Mortality]
650			_a*Lung Neoplasms/mo [Mortality]
650			_a*Mesothelioma/mo [Mortality]
650			_a*Peritoneal Neoplasms/mo [Mortality]
650			_aAdult
650			_aAged
650			_aAged, 80 and over
650			_aChemotherapy, Adjuvant
650			_aCombined Modality Therapy
650			_aFemale
650			_aFollow-Up Studies
650			_aHumans
650			_aLung Neoplasms/pa [Pathology]
650			_aLung Neoplasms/th [Therapy]
650			_aMale
650			_aMesothelioma/pa [Pathology]
650			_aMesothelioma/th [Therapy]
650			_aMiddle Aged
650			_aNeoplasm Staging
650			_aPeritoneal Neoplasms/sc [Secondary]
650			_aPeritoneal Neoplasms/th [Therapy]
650			_aPrognosis
650			_aProspective Studies
650			_aRetrospective Studies
650			_aSurvival Rate
651			_aWashington Cancer Institute
657			_aJournal Article
700			_aBijelic, Lana
700			_aIhemelandu, Chukwuemeka
700			_aSugarbaker, Paul H
790			_aBijelic L, Ihemelandu C, Sugarbaker PH
856			_uhttp://dx.doi.org/10.1245/s10434-014-3977-y _zhttp://dx.doi.org/10.1245/s10434-014-3977-y
942			_cART _dArticle
999			_c1720 _d1720