SO11P CYTOREDUCTIVE SURGERY AND INTRAPERITONEAL CHEMOTHERAPY FOR PERIOTONEAL MESOTHEMLIOMA

Abstract

Purpose: Peritoneal mesothelioma is a rare malignancy regarded as a preterminal condition with few therapeutic options. The aim of this study is to report the results of 25 patients with diffuse peritoneal mesothelioma treated with cytoreductive surgery (CRS) and intraperitoneal chemotherapy (IPC).Methodology: From 1999 to 2008, the clinical and treatment‐related data of 25 patients with primary peritoneal mesothelioma who underwent CRS and IPC were reviewed from a prospective database. The CRS was performed by using peritonectomy procedures and the IPC was performed using Cisplatin, Mitomycin C at 42 degrees Celsius for 90 minutes by using the Coliseum technique.Results: The peri‐operative mortality rate was 4%. The morbidity rates were was 36%, with grade 1 and 2 complications in 9 patients, grade 3 complications in 7 patients and grade 4 complications in 4 patients. The median follow‐up was 15 months (range: 1–89 months). The overall patient median survival after cytoreduction and peri‐operative intraperitoneal chemotherapy was 30 months. The 1‐, 2‐ and 3‐ year actuarial survival was 77%, 61% and 49% respectively. On univariate analyses, the histopathology subtype (p = 0.007) and completeness of cytoreduction (p = 0.013) were identified to be significant prognostic factors for overall patient survival.Conclusion: CRS and IPC for diffuse peritoneal mesothelioma can be performed safely with acceptable morbidity and mortality rates. Compared to historical controls, CRS and IPC have demonstrated improved survival in selected patients. The completeness of cytoreduction and histological subtype were demonstrated to be the major determinants of survival.