Research Article

Peritoneal mesothelioma treated by induction chemotherapy, cytoreductive surgery, and intraperitoneal hyperthermic perfusion

  1. Marcello Deraco MD1,*,
  2. Paolo Casali2,
  3. M.G. Inglese3,
  4. Dario Baratti1,
  5. Elisabetta Pennacchioli1,
  6. Rossella Bertulli3,
  7. Shigeki Kusamura1

Article first published online: 19 JUN 2003

DOI: 10.1002/jso.10255

Issue

Journal of Surgical Oncology

Journal of Surgical Oncology

Volume 83, Issue 3, pages 147–153, July 2003

Additional Information

How to Cite

Deraco, M., Casali, P., Inglese, M., Baratti, D., Pennacchioli, E., Bertulli, R. and Kusamura, S. (2003), Peritoneal mesothelioma treated by induction chemotherapy, cytoreductive surgery, and intraperitoneal hyperthermic perfusion. Journal of Surgical Oncology, 83: 147–153. doi: 10.1002/jso.10255

Author Information

  1. 1

    Department of Surgery, National Cancer Institute of Milan, Milan, Italy

  2. 2

    Department of Medical Oncology, National Cancer Institute of Milan, Milan, Italy

  3. 3

    Department of Anaesthesiology, National Cancer Institute of Milan, Milan, Italy

*Department of Surgery, U.O. Chirurgia Melanoma e Sarcoma, Istituto Nazionale per lo Studio e la Cura dei Tumori, via Venezian 1, 20133 Milan, Italy, www.marcelloderaco.com. Fax: +39-2-23902404.

Publication History

  1. Issue published online: 19 JUN 2003
  2. Article first published online: 19 JUN 2003
  3. Manuscript Accepted: 14 APR 2003

Funded by

  • AIRC (Italian Association for Cancer Research)

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Keywords:

  • peritoneal mesothelioma;
  • peritonectomy;
  • peritioneal chemotherapy

Abstract

Background and Objectives

Peritoneal mesothelioma (PM) is a rare disease, with a poor prognosis. We decided to prospectively evaluate the prognostic impact of aggressive surgery followed by intraperitoneal chemotherapy with local hyperthermia.

Patients and Methods

In this prospective study, 19 patients with PM were treated by cytoreductive surgery (CRS) and intraperitoneal hyperthermic perfusion (IPHP). Mean follow-up was 27 months (range: 1–65). Fifteen (68%) patients had malignant disease, two had well-differentiated papillary mesothelioma, and two had multicystic PM. Thirteen (65%) patients received preoperative chemotherapy. Fifteen cases (75%) underwent optimal cytoreduction (residual disease <2.5 mm). One patient underwent the procedure twice due to locoregional progression. IPHP was performed with closed abdomen technique, using a preheated polysaline perfusate (42.5°C) containing cisplatin + mitomycin C or cisplatin + doxorubicin administered through a heart–lung pump for 60 or 90 min.

Results

Three-year overall and progression-free survival was 69 and 66%, respectively. The operative morbidity (grade II/III), mortality, and overall toxicity (grade I–IV) rates were 25, 0, and 30%, respectively. Seventeen (94%) out of 18 patients had resolution of ascites.

Conclusions

This therapeutic strategy proved feasible and was well tolerated. Early results seem promising and consistent with a potentially major impact on survival in selected patients with PM. J. Surg. Oncol. 2003;83:147–153. © 2003 Wiley-Liss, Inc.

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