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Surgery Plus HIPEC Only ‘Potential for Cure’ of Peritoneal Mesothelioma

Surgery Plus HIPEC Only ‘Potential for Cure’ of Peritoneal Mesothelioma

Among the most promising treatments for peritoneal mesothelioma is a combination of cytoreductive surgery (CRS) and heated chemotherapy called hyperthermic intraperitoneal chemotherapy (HIPEC).
A study published February 2018 in the International Journal of Hyperthermia supports the value of this combination therapy for treating this asbestos-related cancer.
Researchers in the U.K. analyzed 9.5 years of data on 76 peritoneal mesothelioma patients who were treated with CRS and HIPEC.
“The results in this series suggest that CRS and HIPEC, even when complete cytoreduction is not achieved, is of benefit to patients with either low-grade or malignant mesothelioma and at present is the only treatment which has the potential for cure,” the authors wrote.

Using Two Mesothelioma Treatments Together

Peritoneal mesothelioma is a form of cancer that develops in the peritoneum, the tissue lining of the abdomen. It accounts for less than 20 percent of all cases of mesothelioma.
Many of the treatment options for peritoneal mesothelioma are similar to those of other asbestos-related cancers.
For many patients, however, the most promising treatment is a combination of:

  • Cytoreductive Surgery: CRS is a type of debulking surgery. Debulking removes as much of the tumor as possible. When tumor debulking is performed with curative intent and allows for complete removal of all visible cancer, it is called cytoreductive surgery.
  • Hyperthermic Intraperitoneal Chemotherapy: HIPEC places concentrated, heated chemotherapy into the abdomen during surgery. It delivers chemotherapy directly to cancer cells in this area.

Two Categories of Peritoneal Mesothelioma

Peritoneal mesothelioma often is categorized into two groups. Less aggressive tumors with a better prognosis are called low-grade peritoneal mesothelioma.
This category includes the cell types multicystic mesothelioma and well-differentiated papillary mesothelioma.
The other type of this cancer is diffuse malignant peritoneal mesothelioma. These tumors tend to be more aggressive and include epithelioid, biphasic and sarcomatoid subtypes.

Surgery Plus HIPEC Is a Powerful Combination

The U.K. researchers found using these two treatments together was particularly effective for low-grade disease.
“After complete cytoreduction, 100 percent overall survival was observed amongst patients with low-grade disease,” the authors wrote.
The authors also noted in their publication that although the therapies may not cure more aggressive peritoneal mesothelioma cancers, combining surgery and HIPEC can be the most effective treatment in these situations, too.

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