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Mesothelioma

Mesothelioma and the Long Run

Mesothelioma is not a commonly occurring disease. There are only around 3,000 new cases of this condition diagnosed in the United States each year. The rate of mesothelioma went up from 1970 to the early 1990s, but it has since then leveled off and went slightly down. This could be attributed to changes that have been made in employment settings so that workers would not be exposed to asbestos.

The rates of mesothelioma are much lower in women than for men, and it is much more common in Caucasians and Hispanics/Latinos than in Asian and African Americans. Also, the relative 5-year mesothelioma survival rate is proportional with people who survive with cancer for 5 years. For mesothelioma, the 5-year survival rate is between 5 and 10 percent, and people who are diagnosed at a young age are said to live longer than this.

Study Reports New Surgery and Chemotherapy Works for Mesothelioma

Researchers now report hopeful news for peritoneal mesothelioma patients who face the prospect of surgery. A new study published in the Journal of the American College of Surgeons reports on the benefits of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). Both of these treatment techniques are said to have improved survival rates for mesothelioma patients.

The purpose of cytoreductive surgery is to remove as much of the cancerous tissue as possible. Surgeons tend to follow this procedure with a "wash" of warmed chemotherapy drugs, which are put directing into the open body region. HIPEC, the chemotherapy treatment, destroys the remaining mesothelioma cells and prevents new cells of that nature from developing.

The study involved 1,000 patients who underwent cytoreductive surgery and HIPEC. Of these treated patients, 72 had few complications and increased survival for all conditions studied during a 14 year period. The median hospital stay for patients who had cytoreductive surgery and HIPEC treatment was eight days. Patients who were treated most recently tended to do better overall. Researchers attributed this to better patient selection and increased surgical expertise. Also, with increased operative experience, patients had fewer transfusions, less stoma development and fewer serious complications.

Not all Patients are Good Candidates for New Treatment

Not every mesothelioma patient is a good candidate for cytoreductive surgery and HIPEC. Patients who are optimal for these procedures include:

  • Those who are in good overall health.
  • People in the early stages of the disease.
  • Patients who have mesothelioma confined to one body area.
  • Those who have the epithelioid variety of the condition.

The researchers say that when patients are carefully selected and the surgeons are experienced with cytoreductive surgery and HIPEC, their survival outlook appears to be better than ever before. This surgical technique and use of chemotherapy represents a remarkable improvement in outcomes compared to historical data, and it shows that long-term survival is, indeed, possible for select mesothelioma patients.

Conclusions

This study was presented in December of 2013 at the Southern Surgical Association's annual meeting in Virginia. It focuses on two institutions: Wake Forest University School of Medicine and Creighton University School of Medicine. Also, the researchers report that multi-institutional cooperative trials are necessary to perfect the cytoreductive surgical procedure with HIPEC for patients with mesothelioma and other forms of cancer.

Resources:

Levine, EA, "Intraperitoneal Chemotherapy for Peritoneal Surface Malignancy: Experience with 1,000 Patients", December 21, 2013, Journal of the American College of Surgeons, Epub ahead of print.

Cancer.org (2013). Malignant mesothelioma key statistics. Retrieved from:
http://www.cancer.org/cancer/malignantmesothelioma/detailedguide/malignant-mesothelioma-key-statistics

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