| Multicystic peritoneal mesothelioma: outcomes and patho-biological features in a multi-institutional series treated by cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC). | |
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MedLine Citation:
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PMID: 20832234 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIM: This retrospective multi-institutional study addresses the role of surgical cytoreduction and hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of multicystic peritoneal mesothelioma (MCPM). MCPM is an uncommon tumour with uncertain malignant potential and no current standard therapy. Additionally, poorly defined pathological and biological features of this disease were investigated. METHODS: Twelve patients with MCPM underwent 14 procedures of cytoreduction and HIPEC in two Italian referral centres. Nine patients had recurrent disease after previous debulking (one operation in six patients, two in two, four in one). Biological markers related to mesothelioma origin and clinical features were assessed by immunohistochemical studies. RESULTS: Median follow-up was 64 months (range 5-148). Optimal cytoreduction (residual tumour nodules ≤2.5 mm) was performed in all the procedures. One grade IV postoperative complication (NCI/CTCAE v.3.0) and no operative death occurred. All the patients are presently alive with no evidence of disease, including two patients who underwent the procedure twice, due to locoregional disease recurrence. Five- and ten-year progression-free survival was 90% and 72%, accounting for a. statistically significant difference (P = 0.0001) with progression-free survival following previous debulking surgery (median 11 months; range 2-31). All cases showed low proliferative activity assessed by mitotic rate and Ki-67 expression. CONCLUSIONS: MCPM is a borderline tumour with a high propensity to local-regional recurrence. Definitive tumour eradication by means of cytoreduction and HIPEC seems more effective than debulking surgery in preventing disease relapse. Low mitotic rate and poor Ki-67 expression might be related to the peculiar behaviour of MCMP. |
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Authors:
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D Baratti; M Vaira; S Kusamura; S D'Amico; M R Balestra; T Cioppa; E Mingrone; M De Simone; M Deraco |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't Date: 2010-09-15 |
Journal Detail:
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Title: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology Volume: 36 ISSN: 1532-2157 ISO Abbreviation: Eur J Surg Oncol Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-10-12 Completed Date: 2010-11-01 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8504356 Medline TA: Eur J Surg Oncol Country: England |
Other Details:
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Languages: eng Pagination: 1047-53 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 Elsevier Ltd. All rights reserved. |
Affiliation:
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Department of Surgery, Istituto Nazionale per la Cura e lo Studio dei Tumori, Milan, Italy. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Antineoplastic Combined Chemotherapy Protocols / administration & dosage* Chemotherapy, Adjuvant / methods Chemotherapy, Cancer, Regional Perfusion / methods* Disease-Free Survival Female Humans Hyperthermia, Induced* Infusions, Parenteral Kaplan-Meiers Estimate Length of Stay Male Mesothelioma / drug therapy, pathology*, surgery, therapy* Middle Aged Neoplasm, Residual / pathology Patient Selection Peritoneal Neoplasms / drug therapy, pathology*, surgery, therapy* Prognosis Retrospective Studies Surgical Procedures, Operative / methods Treatment Outcome |
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