Successful palliation of malignant ascites from peritoneal mesothelioma by laparoscopic intraperitoneal hyperthermic chemotherapy.
A variety of options have been proposed to treat malignant ascites but most of them have failed to reach a significant impact in terms of palliation. Laparoscopic hyperthermic intraperitoneal chemotherapy (LHIPEC) could represent a good therapeutic tool for patients in whom medical therapies have failed and peritoneovenous shunting is contraindicated. Here we present a case of a 49-year-old woman with malignant ascites secondary to peritoneal spreading of a right pleural mesothelioma. After failure of medical therapy, the patient underwent LHIPEC with Cisplatin 25 mg/m/L and Doxorubicin 7 mg/m/L. A dramatic reduction of ascites was documented in the postoperative period and the patient experienced complete abdominal symptom relief. Ascites did not recur during a follow-up period of 6 months. LHIPEC could be a good therapeutic option to palliate malignant ascites from mesothelioma in cases not eligible for a radical treatment. Further studies are needed to standardize dosage and perfusion parameters.
Patriti
Alberto
A
Section of General and Emergency Surgery, Department of Surgery, University of Perugia, Perugia, Italy. albertopatriti@gmail.com
Cavazzoni
Emanuel
E
Graziosi
Luigina
L
Pisciaroli
Antonio
A
Luzi
Debora
D
Gullà
Nino
N
Donini
Annibale
A
D000970:Antineoplastic Agents / Q000008:administration & dosage; D001201:Ascites / Q000209:etiology / Q000628:therapy*; D010478:Chemotherapy, Cancer, Regional Perfusion / Q000379:methods*; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D007263:Infusions, Parenteral; D010535:Laparoscopy; D008654:Mesothelioma / Q000473:pathology* / Q000628:therapy; D008875:Middle Aged; D010166:Palliative Care; D010534:Peritoneal Neoplasms / Q000473:pathology* / Q000628:therapy
D000970:Antineoplastic Agents