Multicystic mesothelioma: operative and long-term outcomes with cytoreductive surgery and hyperthermic intra peritoneal chemotherapy

Publication date: Available online 14 March 2018
Source:European Journal of Surgical Oncology
Author(s): Eran Nizri, Dario Baratti, Marcello Guaglio, Snita Sinukumar, Antonello Cabras, Shigeki Kusamura, Marcello Deraco
BackgroundMulticystic peritoneal mesothelioma (MCPM) is an extremely rare disease with 40-50% rate of recurrence after surgical debulking. Due to the recurrent nature of the disease, the option of cytoreductive surgery combined with hyperthermic peritoneal chemotherapy (HIPEC) was offered for this condition. In the present study we aimed to describe the outcomes of this strategy in a single center cohort.MethodsWe retrospectively reviewed a prospectively collected database of all patients with MCPM that underwent the combined procedure in our center. Clinical presentation, operative procedures and outcomes were reviewed.ResultsBetween August 1997 and October 2017, 19 patients with MCPM underwent 20 cytoreduction and HIPEC procedures in our center. The majority of the patients were females (n=17, 89%), and mean age was 42, as reported in other series. Disease extent, as measured by mean peritoneal carcinomatosis index (PCI) was 15.5±9.9 and total number of procedures performed 6.7±2.6. Major complications occurred in 3 (15%) patients, with no perioperative mortality. After a median of follow-up of 69 months (range 4-220) all patients were alive and 4 patients had recurrence (21%). Patients with high PCI (defined by median PCI) had shorter relapse free survival (RFS) than patient with low PCI (mean RFS= 106.4±6.6 for high PCI vs. 125.6±34.1 for low PCI, p=0.03).ConclusionCytoreduction and HIPEC offer low recurrence rate and prolonged mean RFS for patients with MCPM. The combined procedure can be offered with acceptable morbidity in specialized centers.



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