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Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy for peritoneal mesothelioma: patient selection and special considerations

Authors Enomoto LM, Shen P, Levine EA, Votanopoulos KI

Received 21 December 2018

Accepted for publication 26 March 2019

Published 7 May 2019 Volume 2019:11 Pages 4231—4241

DOI https://doi.org/10.2147/CMAR.S170300

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Ms Justinn Cochran

Peer reviewer comments 2

Editor who approved publication: Professor Lu-Zhe Sun


Laura M Enomoto, Perry Shen, Edward A Levine, Konstantinos I Votanopoulos

Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston Salem, NC 27157, USA

Abstract: Malignant peritoneal mesothelioma (MPM) is a rare, aggressive malignancy that typically presents with vague symptoms, ascites, and/or diffuse peritoneal studding. Despite findings of advanced disease within the peritoneal cavity, spread beyond the abdomen is uncommon. Although advances in systemic chemotherapy have been made, cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) remain the mainstay of treatment. Median overall survival of approximately 50 months with CRS/HIPEC has been demonstrated, with age, gender, histologic subtype, peritoneal carcinomatosis index, comorbidities, nodal and extra-abdominal metastases, and completeness of cytoreduction all playing a role in prognosis. In patients with refractory malignant ascites and unresectable disease, complete resolution of ascites and improvement in quality of life have been demonstrated with palliative HIPEC. In appropriately selected patients, CRS/HIPEC plays a critical role in the treatment and palliation of MPM.

Keywords: malignant peritoneal mesothelioma, cytoreductive surgery, hyperthermic intraperitoneal chemotherapy, peritoneal surface disease

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