Study Shows Second HIPEC Boosts Survival Odds in Peritoneal Mesothelioma, According to Surviving Mesothelioma

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Peritoneal mesothelioma patients who have a second heated chemotherapy treatment after surgery may more than double their odds of survival.

Patients who are candidates for repeat HIPEC may derive an even greater overall survival advantage.

Surviving Mesothelioma reports that researchers at Tampa’s Moffitt Cancer Center have demonstrated a significant survival advantage among mesothelioma patients who undergo a repeat heated chemotherapy treatment for peritoneal mesothelioma.

The new study published in the Annals of Surgical Oncology included 29 peritoneal mesothelioma patients who had cytoreductive surgery at Moffitt between June 2004 and March 2012. Cytoreduction involves removing as much of the mesothelioma tumor from the abdomen as possible. All but three of these patients also had heated intraperitoneal chemotherapy (HIPEC), which consists of rinsing the open body cavity with the drug cisplatin in an effort to destroy any cancer cells left behind. The cytoreduction/HIPEC approach has become the standard of care for peritoneal mesothelioma patients who are healthy enough to undergo the procedure.

Of the 26 patients who had cytoreduction and HIPEC, 8 went back in later for a second HIPEC treatment. While there were no differences between the first and second procedures in terms of surgery length, blood loss, or hospital stay, the patients who had a second HIPEC experienced 15% fewer complications after the second treatment than they had after their first. They also experienced a significant survival advantage over patients who did not have a second treatment.

The median overall survival for all mesothelioma patients in the study, whether they had one, two, or no HIPEC treatment, was 41.2 months. Patients who had one HIPEC treatment after their initial surgery had a median overall survival of 27.2 months. But patients who had a repeat HIPEC treatment had a median overall survival of 80 months. While these patients may have been healthier to begin with, since a patient must be in relatively good health even to be a candidate for a second treatment, the research team says their data give a boost to the use of repeat HIPEC for peritoneal mesothelioma.

"Cytoreduction and HIPEC for malignant peritoneal mesothelioma are associated with longer overall survival. Patients who are candidates for repeat HIPEC may derive an even greater overall survival advantage," writes lead author Joyce Wong, MD. The original study appears in a recent issue of the Annals of Surgical Oncology. (Wong, J, et al, "Repeat Cytoreductive Surgery and Heated Intraperitoneal Chemotherapy May Offer Survival Benefit for Intraperitoneal Mesothelioma: A Single Institution Experience", October 25, 2013, Annals of Surgical Oncology, Epub ahead of print.

Peritoneal mesothelioma is a rare form of one of the rarest cancers. Mesothelioma, a virulent cancer triggered by asbestos exposure, affects about 2,500 Americans each year and thousands more around the world. Peritoneal mesothelioma accounts for a little less than 30 percent of those cases.

For nearly ten years, Surviving Mesothelioma has brought readers the most important and ground-breaking news on the causes, diagnosis and treatment of mesothelioma. All Surviving Mesothelioma news is gathered and reported directly from the peer-reviewed medical literature. Written for patients and their loved ones, Surviving Mesothelioma news helps families make more informed decisions.

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Michael Ellis
Cancer Monthy
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