Document Detail


Multicystic peritoneal mesothelioma: outcomes and patho-biological features in a multi-institutional series treated by cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC).
MedLine Citation:
PMID:  20832234     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
D Baratti; M Vaira; S Kusamura; S D'Amico; M R Balestra; T Cioppa; E Mingrone; M De Simone; M Deraco
Related Documents :
21421464 - Multimodal treatment of desmoid tumours: the significance of local control.
12928004 - Future directions in the surgical management of ovarian cancer.
6186354 - The treatment of stage iii nonseminomatous testicular tumors. roswell park memorial ins...
6766604 - Retroperitoneal metastases from ovarian carcinoma: reassessment of 365 patients studied...
11595134 - Aberrant expression of p21(waf1/cip1) and p27(kip1) in cervical carcinoma.
2986824 - Chemotherapy-induced remission in a patient with small cell carcinoma of the lung and h...
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2010-09-15
Journal Detail:
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:
Created Date:  2010-10-12     Completed Date:  2010-11-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8504356     Medline TA:  Eur J Surg Oncol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1047-53     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Ltd. All rights reserved.
Affiliation:
Department of Surgery, Istituto Nazionale per la Cura e lo Studio dei Tumori, Milan, Italy.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
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

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Aortic rupture after spinal correction for scoliosis in the presence of a thoracic stent graft.
Next Document:  [Haemodynamic monitoring or output cardiac monitoring?].