Treatments of malignant peritoneal mesothelioma: A retrospective study on 47 cases.

Quoted from http://meeting.ascopubs.org/cgi/content/abstract/28/15_suppl/e14611

          

Treatments of malignant peritoneal mesothelioma: A retrospective study on 47
cases.

Y. Wang, X. Ning and S. Chen

Peking Union Medical College Hospital, Beijing, China

Journal of Clinical Oncology, 2010 ASCO Annual Meeting Proceedings (Post-Meeting Edition).
Vol 28, No 15_suppl (May 20 Supplement), 2010:e14611
© 2010 American Society of Clinical Oncology

Abstract

Background: Malignant peritoneal mesothelioma (MPM) is a rare disease and prognosis is poor. The optimal treatment is still uncertain.

Methods: A retrospective study on 47 patients with MPM treated by cytoreduction surgery (CRS), systemic chemotherapy and intraperitoneal (IP) in our institution from 1985 to 2006 was
established. The primary end point was overall survival. The secondary end point was evaluation of prognostic variables for overall survival.

Results: Follow-up was complete in all patients. The mean age was 51 years (standard deviation [SD], 12 years). Sixteen patients (34%) had diffused disease without organ involvement. Eleven patients (23%) had organ involvement. Eleven patients (23%) had
diaphragm or abdominal wall involvement. Nine patients (19%) hadpositive lymph nodes. Twenty-one patients (44.7%) received CRS, platinum-based chemotherapy (GC: gemcitabine plus cisplatin; MIC mitomycine, isofomine plus cisplatin; PC: paclitaxel with cisplatin) and IP sequentially. Twenty-six patients (55.3%) treated by chemotherapy and IP sequentially. Nontreatment-related death and toxicity was well telorated. Twenty-six patients received second-line chemotherapy. The average time of overall survival was 18.1 months (95%CI,11.9-24.2) in CRS group and 10.0 months (95%CI, 7.7-12.3) in non CRS group, p = 0.011. Four prognostic factors which related to advance of disease were independently associated with poor survival in the multivariate analysis: organ involvement (p < 0.001), diaphragm or abdominal wall involvement (p < 0 .01), lymph node metastasis (p < 0 .01). 

Conclusions: The data suggest that CRS combined with systemic chemotherapy and IP which used sequentially achieved prolonged survival in selected patients. Organ involvement, diaphragm orabdominal wall involvement and lymph node metastasis independently correlated with decreased survival following comprehensive treatment.