Multicystic peritoneal mesothelioma treated by surgical cytoreduction and hyperthermic intra-peritoneal chemotherapy (HIPEC).
BACKGROUND
Multicystic peritoneal mesothelioma (MPM) is an extremely uncommon lesion with uncertain malignant potential. Multiple recurrences after surgical interventions and transition to aggressive malignancies have been reported. Here, we review our experience with cytoreduction and hyperthermic intraperitoneal chemotherapy (HIPEC) in the management of MPM.


METHODS
Five women with MPM underwent 6 procedures of cytoreduction and close-abdomen HIPEC with cisplatin and doxorubicin. Three patients had recurrent disease after 1, 2 and 4 previous debulkings, respectively.


RESULTS
Optimal cytoreduction (residual tumor nodules < or =2.5 mm) was performed in all the procedures. One grade 4 postoperative complication (NCI/CTCAE v.3.0) and no operative mortality occurred. Median follow-up was 31 months (range 3-102). MPM recurred in two patients: one is presently disease-free after a second cytoreduction with HIPEC and the other is alive with minimal stable disease.


CONCLUSIONS
Definitive eradication by means of cytoreduction and HIPEC seems a safe and effective therapeutic option for MPM.
Baratti
D
D
Department of Surgery, National Cancer Institute, Milan, Italy.
Kusamura
S
S
Sironi
A
A
Cabras
A
A
Fumagalli
L
L
Laterza
B
B
Deraco
M
M
D000328:Adult; D010478:Chemotherapy, Cancer, Regional Perfusion; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D018261:Mesothelioma, Cystic / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D018365:Neoplasm, Residual / Q000473:pathology / Q000628:therapy; D010534:Peritoneal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D012086:Reoperation; D015996:Survival Rate; D016896:Treatment Outcome