Surgery Plus Chemotherapy May Help Peritoneal Mesothelioma Patients

WASHINGTON, DC — June 2, 2006 — The length of survival for peritoneal mesothelioma patients who have undergone surgery as well as chemotherapy may be several years, according to a recent study at the Washington Cancer Institute (Eur J Surg Oncol., 2006 Apr 15). This is in contrast to those patients with peritoneal mesothelioma who have been treated with chemotherapy only or with radiation and who generally survive for one year or less.

Mesothelioma is an aggressive cancer that first attacks the membranes surrounding the lungs (pleural mesothelioma) or the stomach (peritoneal mesothelioma). Peritoneal mesothelioma is the rarer form of the cancer, making up about one–quarter of mesothelioma cases.

Surgery involving the abdominal membranes was performed on 65 patients at the Washington Hospital Center in order to remove mesothelioma cancer cells. This is called cytoreductive or debulking surgery, a procedure that can last several hours. Sometimes it is necessary to also remove segments of the stomach.

During surgery, the patients received the standard chemotherapy drugs cisplatin and doxorubicin. The drug solution was warmed and administered into their abdominal cavities, a procedure known as “hyperthermic intraoperative intraperitoneal chemotherapy” or HIIC.

After surgery, the mesothelioma patients were treated for five days with paclitaxel (TAXOL®), a chemotherapy drug that is generally used by breast cancer patients. Cisplatin and doxorubicin are platinum–based compounds that are thought to inhibit the growth of cancer cells. TAXOL® also slows or stops cancer cell growth.
Survival Time Increased for Peritoneal Mesothelioma Patients

The median length of survival among the 65 peritoneal mesothelioma patients was 79 months, and they were also freed from the build–up of excess fluid in their stomach cavities. When surgeons were able to remove most of a mesothelioma tumor (“adequate cytoreduction”), the patient had a better chance of survival than did a patient who had a larger remaining tumor after surgery (“suboptimal cytoreduction”). The researchers pointed out that a patient with a mesothelioma tumor greater than five centimeters in the upper abdominal area would not be a good candidate for surgery, as the result would likely be suboptimal cytoreduction. They suggested using CT scans to determine tumor size when selecting patients for the surgery/chemotherapy treatment procedure.

The Washington Cancer Institute researchers also reviewed other peritoneal mesothelioma reports from Maryland, New York, Italy and France. In these studies, about half the patients with peritoneal mesothelioma were alive after five years if they were treated with surgery as well as chemotherapy using HIIC techniques.
Learning More About Surgery and Peritoneal Mesothelioma

For more detailed information about peritoneal mesothelioma surgery, see the web site, Peritonectomy.com. In addition, an article by Dr. Paul Sugarbaker, one of the authors of the Washington Cancer Institute study, describes cytoreductive surgery and provides illustrations.

Please feel free to contact us at Brayton Purcell if you have mesothelioma and would like legal information. We have been handling cases involving mesothelioma and asbestos exposure for over 20 years and can provide support, information, and excellent advocacy.

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