From the blog

Peritoneal Mesothelioma Surgery with More organ Removal Can Help Survival

Published: December 4, 2020

Mesothelioma surgery that removes more of an organ has been found to extend the survival of patients. It also did not increase the chance of severe complications nor did it change the survival benefits of aggressive surgery on patients with peritoneal mesothelioma. The complex surgery also did not negatively affect long term survival outcomes. This is compared to cytoreduction surgery that does not completely remove organs leading to an increased mortality and a shorter overall survival.

The study looked at 174 peritoneal mesothelioma patients at 12 different treatment centers around the United States. Peritoneal mesothelioma is a very aggressive cancer that spreads to other organs from the abdomen. Most patients are treated with a combination of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. It has a varying range of effectiveness allowing patients to live between two and 10 years after their diagnosis. If patients do not receive treatment, the median survival ends up being six to 12 months.

A little over half of the patients in the study (54 percent) only underwent a peritoneal resection, which is surgery that removes the internal lining of the abdomen. These patients were labeled MOR-0. Another group labeled MOR-1 (consisting of 25.9 percent of the patients) had a major organ removed and the other group labeled MOR-2 (20.1 percent of the patients) had two or more major organs removed. Major organ removal is considered a total or partial removal of the diaphragm, stomach, spleen, pancreas, small bowel, colon, rectum, kidney, ureter, bladder, or uterus. These are the organs that peritoneal mesothelioma usually spreads to.

The MOR-1 and MOR-2 groups had more complications post-surgery, which were similar for the two groups. Patients in the MOR-1 and MOR-2 group also had to stay in the hospital for a longer period of time. Hospital readmission and the 30-day mortality were not affected by the MOR status however. The median overall survival was 86 months, which could be broken down to 130 months for MOR-0, 56 months for MOR-1, and 93 months for MOR-2. The study was able to conclude that the level of surgery someone received was not a determining factor for their survival. Survival was affected by age, sex and a patient’s overall health.

Mesothelioma is a cancer of the mesothelium, which surrounds different organs including the lungs, abdomen, and testicles. There is no cure, but different clinical trials have helped extend the lives of patients and improve their quality of life. Studies like this one need to continue to potentially find a cure or at least improve mesothelioma sufferers’ lives.

David Roife et al., “CRS/HIPEC with Major Organ Resection in Peritoneal Mesothelioma Does not Impact Major Complications or Overall Survival: A Retrospective Cohort Study of the US HIPEC Collaborative” Annals of Surgical Oncology (December 2020). [Link]
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