Abstract:
Objective To explore the perioperative safety and efficacy of cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy(HIPEC)for the treatment of malignant peritoneal mesothelioma (MPM).
Methods The clinical and survival data of 20 patients with MPM treated in Aerospace Center Hospital from January 2015 to Jun 2020 were analyzed retrospectively.The safety of the CRS+HIPEC was evaluated, and prognostic factors were determined by univariate and multivariate analyses.
Results There were 20 patients enrolled in this study, including 8 men and 12 women (sex ratio: 1:1.5).In all cases, the pathology was MPM and they were classified to be of the epithelial type.After CRS+HIPEC, the 1-, 2-, and 3-year overall survival rates were 73.9%, 58.2%, and 43.6%, respectively, and the 3-year survival rate of patients with complete cytoreduction(CC-0/1)was 75%.Sex (P=0.295), abnormal CA125 levels (P=0.256), history of surgery (P=0.460), and intravenous chemotherapy (P=0.283) had no significant effect on overall survival.Age over 60 years (P=0.037), incomplete cytoreduction(CC-2/3)(P=0.027), and a peritoneal cancer index (PCI)≥20(P=0.014) were risk factors for poor prognosis.
Conclusions MPM is a rare disease that is difficult to diagnose early and has a poor prognosis after traditional treatment.Intravenous chemotherapy does not confer any survival benefit in this patient population.The comprehensive treatment strategy involving CRS combined with HIPEC should be used in experienced centers as it is safe, reliable, and can significantly prolong overall survival.