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Mesothelioma
Treatment
Articles
and Abstracts
Results
of treatment of 33 patients with
peritoneal mesothelioma.
Br
J Surg 2000 Nov;87(11):1587-93
Sebbag
G, Yan H, Shmookler BM, Chang D,
Sugarbaker PH.
Washington
Cancer Institute, DC 20010, USA.
BACKGROUND:
Peritoneal mesothelioma is a rare
peritoneal malignancy, representing
approximately one-third of all
mesotheliomas. It is regarded as a
universally fatal cancer with few
treatment options.
METHODS:
Records of 33 patients with peritoneal
mesothelioma were reviewed
retrospectively. Demographic, clinical and
quantitative prognostic indicators were
evaluated and analysed statistically using
survival as endpoint. Patients were
treated by a uniform strategy involving
cytoreductive surgery with peritonectomy
procedures and perioperative
intraperitoneal chemotherapy (cisplatin,
doxorubicin).
RESULTS:
There were ten women and 23 men; mean age
was 53.0 years. Asbestos exposure was
recorded in five patients and a family
history of cancer in 13. Presentation was
mainly abdominal distension and pain.
Median survival was 31.0 months; overall
projected survival at 3 years was 56 per
cent. The most significant positive
predictive factors of survival were:
female sex (P= 0.003), low prior surgical
score (P=0.002), completeness of
cytoreduction (P=0.0002) and second-look
surgery (P=0.019). The morbidity rate for
this combined treatment was 33 per cent
and the perioperative mortality rate was 3
per cent.
CONCLUSION:
Although peritoneal mesothelioma is rare,
progress in its management has occurred.
Survival has been extended and selection
factors by which patients may be allocated
to aggressive management strategies have
been defined.
PMID:
11091251 [PubMed - indexed for
MEDLINE]
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