Annals of Surgical Oncology Sign the Guestbook
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
10.1245/s10434-007-9475-8
Annals of Surgical Oncology 14:2790-2797 (2007)
© 2007 Society of Surgical Oncology
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Baratti, D.
Right arrow Articles by Deraco, M.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Baratti, D.
Right arrow Articles by Deraco, M.

Original Article

Multicystic and Well-differentiated Papillary Peritoneal Mesothelioma Treated by Surgical Cytoreduction and Hyperthermic Intra-peritoneal Chemotherapy (HIPEC)

D. Baratti, MD1, S. Kusamura, MD1, D. Nonaka, MD2, G. D. Oliva, MD1, B. Laterza, MD1 and M. Deraco, MD1

1 Department of Surgery, National Cancer Institute, Milan, Italy
2 Department of Pathology, National Cancer Institute, Milan, Italy

Correspondence: Address correspondence and reprint requests to: M. Deraco, MD; E-mail: marcello.deraco{at}istitutotumori.mi.it

Background: Multicystic peritoneal mesothelioma (MPM) and well-differentiated papillary peritoneal mesothelioma (WDPPM) are exceedingly uncommon lesions with uncertain malignant potential and no uniform treatment strategy. The aim of the current study was to review our experience with cytoreduction and hyperthermic intraperitoneal chemotherapy (HIPEC) in these clinical settings.

Methods: Four women with MPM and eight with WDPPM underwent 13 procedures of cytoreduction and close-abdomen HIPEC with cisplatin and doxorubicin. Seven patients had recurrent disease after previous debulking (one operation in five patients, two in one, four in one). Potential clinicopathological prognostic factors were assessed.

Results: Optimal cytoreduction (residual tumor nodules ≤2.5 mm) was performed in 12 of 13 procedures. Median follow-up was 27 months (range 6–94). One grade 4 postoperative complication (NCI/CTCAE v.3.0) and no operative mortalities occurred. One patient underwent the procedure twice due to locoregional MPM recurrence. Transition of typical WDPPM to malignant biphasic mesothelioma was documented in one patient who died of disease progression following incomplete cytoreduction and HIPEC. Following multimodality treatment, 5-year overall and progression-free survival were 90.0% (standard error = 9.0) and 79.7% (11.9), respectively. Progression-free survival following previous debulking surgery (median 24 months; range 2–87) was statistically worse (P = .0156). Incomplete cytoreduction and poor performance status correlated to both reduced overall and progression-free survival after cytoreduction and HIPEC.

Conclusions: MPM and WDPPM are borderline tumors capable of transformation into potentially lethal processes. Definitive tumor eradication by means of cytoreduction and HIPEC seems more effective than debulking surgery in preventing disease recurrence or transition to aggressive malignancies.

Key Words: Multicystic peritoneal mesothelioma • Well-differentiated papillary peritoneal mesothelioma • Peritonectomy • Hyperthermic intraperitoneal chemotherapy; HIPEC






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2007 by the Society of Surgical Oncology.