title: Malignant peritoneal mesothelioma: treatment with maximal cytoreductive surgery plus intraperitoneal chemotherapy.
abstract: OBJECTIVE
  To report survival results in patients with diffuse malignant peritoneal mesothelioma (MPM) treated with maximal cytoreductive surgery followed by immediate intraperitoneal chemotherapy, and to compare them with the median survival of 12-24 months obtained with the standard treatment based on systemic chemotherapy.
  
  
  METHODS
  Twenty-six patients underwent this new regional approach and a median follow-up of 55 months was achieved after this treatment. Complete cytoreductive surgery (residual disease < 2 mm) was performed in all but one patient. Intraperitoneal chemotherapy was performed with hyperthermia (4245 degrees C) and oxaliplatin in 22 patients. The last 12 patients additionally received irinotecan. Data were prospectively verified and retrospectively analyzed.
  
  
  RESULTS
  One patient died postoperatively (4%), and morbidity attained 54%. The median survival exceeded 100 months and the overall 5-year survival rate was 63%. This small series lacks the statistical power required to conduct a well-grounded study on prognostic factors, particularly as the completeness of the surgery is not analyzable here. However, the low-grade histological types had a better disease-free survival rate that was of borderline significance compared to their high-grade counterparts.
  
  
  CONCLUSIONS
  This new approach combining complete cytoreductive surgery considerably increases the survival of patients with MPM compared with the standard treatment based on systemic chemotherapy.
authors.affiliation: Département de chirurgie générale oncologique, Institut Gustave-Roussy, 39 rue Camille-Desmoulins, Villejuif Cedex.
authors.forename: Dominique
authors.initials: D
authors.lastname: Elias
authors.forename: Valérie
authors.initials: V
authors.lastname: Bedard
authors.forename: Tarek
authors.initials: T
authors.lastname: Bouzid
authors.forename: Pierre
authors.initials: P
authors.lastname: Duvillard
authors.forename: Niaz
authors.initials: N
authors.lastname: Kohneh-Sharhi
authors.forename: Bruno
authors.initials: B
authors.lastname: Raynard
authors.forename: Diane
authors.initials: D
authors.lastname: Goere
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D002166:Camptothecin / Q000031:analogs & derivatives / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D010478:Chemotherapy, Cancer, Regional Perfusion; D002945:Cisplatin / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D006979:Hyperthermia, Induced; D000077146:Irinotecan; D008297:Male; D008654:Mesothelioma / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D000077150:Oxaliplatin; D010534:Peritoneal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D011355:Prodrugs / Q000627:therapeutic use; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D011355:Prodrugs; D000077150:Oxaliplatin; D000077146:Irinotecan; D002945:Cisplatin; D002166:Camptothecin