A study recently published in the European Journal of Surgical Oncology investigated a treatment approach that repeats both cytoreductive surgery and heated chemotherapy in an effort to improve life expectancy.
Malignant mesothelioma is a rare form of cancer caused by asbestos exposure. The most common form of the cancer affects the lungs and is called pleural mesothelioma; the second most common form is peritoneal mesothelioma, which affects the lining of the abdominal cavity. The cancer has earned a reputation as being difficult to treat, and no cure has been established. Some patients who are diagnosed early may qualify for a combination of treatments (known as multimodality therapy) with hopes of improving their mesothelioma life expectancy.
Authors of the study explain, “Most centers favor aggressive operative cytoreduction, accepting high morbidity and mortality. In our trials, patients underwent less extensive cytoreduction followed by prolonged intraperitoneal chemotherapy. Patients underwent a second cytoreduction with heated intraperitoneal chemotherapy.”
A total of 47 first cytoreductive surgeries were performed and 29 second surgeries were conducted, with 13percent and 26 percent morbidity, respectively. Infections were the cause of 59 percent of morbidity. Results showed overall median survival was 54.9 months, and median survival for the epithelial mesothelioma subtype was 70.2 months.
In conclusion, researchers report, “A two-stage cytoreduction with intraperitoneal chemotherapy offers median survival comparable to one-stage protocols, with relatively low morbidity, mortality, visceral resections and length of stay despite two operations. This series supports that our protocol is a feasible and safe approach.”
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