Malignant peritoneal mesothelioma is cancer that develops in the abdominal cavity (peritoneal cavity), as spots on the lining of the intestines and the cavity. Peritoneal cases account for approx. 18%- 20% of all mesothelioma diagnoses, with approximately 400 new cases in the USA each year. This research has been reported in The Mesothelioma Caner Alliance Blog at Meothelioma.com.
Most patients (98%) were exposed to asbestos for an average of 28 years but the exposed time varied greatly (±14 years). Symptoms of peritoneal mesothelioma included abdominal pain and bloating, weight loss, shortness of breath, change to abnormal bowel movements (diarrhoea or constipation), and chest pain. Survival time ranged from 6 to 12 monthsand the average survival time was 16.2±13.9 months.
Cytoreductive surgery for peritoneal mesothelioma reduces the tumour burden by removing the tumour nodules. Surgeons usually focus on removing tumour nodules of at least 1cm in size. The surgeon searches for nodules on the lining of the abdominal cavity, and the organs, including the 22 feet of small intestines and 4.9 feet of the large intestines. Hyperthermic intraperitoneal chemotherapy (HIPEC) is delivered afterwards. It means that the chemotherapy is delivered at a warm temperature (about 100°F) as it is more effective against the tumour cells.
The coupling of cytoreductive therapy and hyperthermic intraperitoneal chemotherapy boasts a 5 year overall survival rate of 29%-63% and a median overall survival of 77 months. The combined therapies are considered a potential cure for peritoneal mesothelioma.
However, peritoneal mesothelioma recurs in some treated patients. About 21% of patients who initially received cytoreductive surgery and HIPEC received a second round of cytoreductive surgery. Most of the patients (64%) also received hyperthermic intraperitoneal chemotherapy. They received it on average within 12 months of the first treatment series.
The average overall survival of patients who received the reiterative surgery and HIPEC was slightly shorter at 54 months.
In comparison, patients who received cisplatin based chemotherapy for peritoneal mesothelioma had a median overall survival time of 15 months. Thus, the patients who can tolerate the cytoreductive therapy and heated chemotherapy usually live longer.
Survival rates at one year for pemetrexed treated group were 41.5% and the pemetrexed and cisplatin treated group was 57.4%.
Patients treated with reiterative cytoreduction therapy and warmed chemotherapy in Ihemelandu et al’s study had a 2% rate of severe illness that required surgical or radiological intervention with or without anesthesia (class III) or life-threatening complication such as CNS dysfunction, failure of one or more organs. In comparison, the same patients who received the first round of cytoreduction therapy had a 17% rate of severe illness.
Thus, cytoreduction therapy provides greater survival benefits to patients with peritoneal mesothelioma of the epithelioid cell type than to patients with the mixed or sarcomatoid types. The cytoreduction surgeries have a risk of severe complications and will depend on the patients individual circumstance.
If you or a family member have been affected by mesothelioma, please contact us today on Freephone 0800 294 3065, or talk to us on live chat where we will be happy to answer any questions that you may have.