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Repeat Cytoreductive Surgery and Heated Intraperitoneal Chemotherapy May Offer Survival Benefit for Intraperitoneal Mesothelioma: A Single Institution Experience

  • Regional Cancer Therapies
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Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Introduction

Cytoreduction with heated intraperitoneal chemotherapy (HIPEC) has demonstrated improved overall survival (OS) in malignant peritoneal mesothelioma (MPM). The role of repeated HIPEC for MPM is less clear.

Methods

An institutional review board-approved database of MPM patients was analyzed for clinical factors and outcomes.

Results

From June 2004 to March 2012, 29 patients underwent surgical treatment for mesothelioma. HIPEC was aborted in 3 and completed in 26; 8 underwent additional repeat HIPEC. The majority was male (62 %), median age 66 years. There was no significant difference in surgery duration, blood loss, or hospital-stay-duration between initial and repeat HIPEC. Cisplatin was the chemotherapy used. Complications occurred in 17 (65 %) initial and 6 (50 %) repeat HIPEC, with wound complications being most common. Reoperation was less common (4 % initial and 25 % repeat), and perioperative death was rare (4 % initial, 0 % repeat). Fourteen (54 %) initial and seven (58 %) repeat HIPEC patients received adjuvant chemotherapy. Median time from HIPEC to initiation of chemotherapy was not different between initial and repeat HIPEC (8.8 and 4.6 months, respectively, p = 0.68). Median treatment-free time (time from initial to repeat HIPEC or chemotherapy) also was not different between initial and repeat HIPEC (8.8 and 6.3 months, respectively, p = 0.92). Median OS for the cohort was 41.2 months. Patients who underwent repeat HIPEC had improved median OS (80 months) versus single HIPEC (27.2 months; p = 0.007). A lower peritoneal carcinoma index and complete cytoreduction were associated positively with OS.

Conclusions

Cytoreduction and HIPEC for MPM are associated with longer OS. Patients who are candidates for repeat HIPEC may derive an even greater OS advantage.

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Authors and Affiliations

  1. Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL, USA

    Joyce Wong MD, Abigail L. Koch MD, Jeremiah L. Deneve MD & Sophie Dessureault MD

  2. Department of Biostatistics, Moffitt Cancer Center, Tampa, FL, USA

    William Fulp PhD

  3. Department of Thoracic Oncology, Moffitt Cancer Center, Tampa, FL, USA

    Tawee Tanvetyanon MD

Authors
  1. Joyce Wong MD
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  2. Abigail L. Koch MD
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  3. Jeremiah L. Deneve MD
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  4. William Fulp PhD
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  5. Tawee Tanvetyanon MD
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  6. Sophie Dessureault MD
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Corresponding author

Correspondence to Joyce Wong MD.

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Wong, J., Koch, A.L., Deneve, J.L. et al. Repeat Cytoreductive Surgery and Heated Intraperitoneal Chemotherapy May Offer Survival Benefit for Intraperitoneal Mesothelioma: A Single Institution Experience. Ann Surg Oncol 21, 1480–1486 (2014). https://doi.org/10.1245/s10434-013-3341-7

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  • DOI: https://doi.org/10.1245/s10434-013-3341-7

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