Cytoreductive surgery and intraperitoneal chemotherapy for peritoneal mesothelioma.
OBJECTIVE
Peritoneal mesothelioma is a rare disease and traditionally has been associated with a gloomy prognosis. The present study aimed to report the outcomes following surgery and intraperitoneal chemotherapy in selected patients with peritoneal mesothelioma.


METHODS
Clinicopathological features, operative procedures, early outcomes and survival were analysed for 17 consecutive patients who underwent surgery for peritoneal mesothelioma between 1998 and 2007. Seventeen consecutive patients who underwent surgery for peritoneal mesothelioma between 1998 and 2007 were analysed for clinicopathological features, operative procedures, early outcomes and survival.


RESULTS
Seventeen patients underwent 18 laparotomies. Most presented with abdominal distension (71%) and abdominal pain or discomfort (53%). Complete cytoreduction was achieved in 8 patients, major debulking in 8, and 1 patient had an exploratory laparotomy only due to extensive disease. One patient died on day 30 postoperatively due to a chest infection and pulmonary embolism. The median survival for 8 patients who underwent complete cytoreduction was 3.7 years (range, 0.7-6.9), whereas that for 8 patients with palliative debulking was 1.0 years year (range, 0.3-5.7). Among the 12 patients who had significant ascites as a presenting symptom, 10 reported good palliation of ascites.


CONCLUSIONS
Cytoreductive surgery combined with intraperitoneal chemotherapy appears to be the optimal treatment for selected patients with peritoneal mesothelioma. Increased familiarity with this condition's presentation and natural history, and knowledge of available treatment options, will hopefully facilitate treatment of these patients and expedite speedy referral to appropriate treatment centres.
Yano
H
H
Pseudomyxoma Peritonei Centre, Colorectal Research Unit, Basingstoke and North Hampshire Foundation Trust, Aldermaston Road, Basingstoke RG24 9NA, Hampshire, UK.
Moran
B J
BJ
Cecil
T D
TD
Murphy
E M
EM
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral; D008297:Male; D008654:Mesothelioma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D018579:Patient Selection; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications; D011446:Prospective Studies; D016019:Survival Analysis