Cytoreductive completeness, a measure of how thoroughly a mesothelioma tumor is removed, has far greater impact on peritoneal mesothelioma outcomes than any other factor, according to a recent study in The American Surgeon.
Mesotheliomas are aggressive neoplasms, or tumors, resulting from mesothelial cells lining the pleura, peritoneum, and other body organs.
Diffuse malignant peritoneal mesothelioma (DMPM) is a rare and difficult to treat malignancy. However, cytoreductive surgery for mesothelioma (CRS), which involves removing tumors in the abdomen, when combined with hyperthermic intraperitoneal chemotherapy (HIPEC), has been found to improve patients’ life expectancy.
To examine the outcomes of DMPM patients treated with CRS and HIPEC, cancer surgeons at the Mercy Institute for Cancer Care in Baltimore tracked 23 people treated there between 1999 and 2014. Age at diagnosis, age at surgery, previous surgeries, follow-up time, gender, peritoneal cancer index (PCI) score, completeness of cytoreduction, pathology, and overall survival (OS) were the mesothelioma prognostic factors analyzed by the research team.
Results from a univariate statistical analysis showed that cytoreductive completeness emerged has the only significant prognostic factor.
“The completeness of cytoreduction is the most significant prognostic factor for long-term survival,” said Dr. Armando Sardi, one of the study’s authors, according to a news release. The researchers also suggested that patients with DMPM may achieve long-term survival when treated with CRS/HIPEC.
“This study really emphasizes just how important it is for mesothelioma patients to have their surgeries done by highly experienced cancer surgeons who are likely to achieve the most complete cytoreduction,” saidAlex Strauss, managing editor of Surviving Mesothelioma.
Malignant peritoneal mesothelioma accounts for about 30 percent of all mesotheliomas, and its symptoms range from fever, abdominal pain, and ascites, to vomiting, diarrhea, and abdominal mass. Exposure to asbestos is the main known cause of mesotheliomas.