BACKGROUND: Due to the increased adoption of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), patients with malignant peritoneal mesothelioma (MPM) have seen improved outcomes. We aimed to evaluate and synthesize the recent published literature. METHODS: The review was conducted according to the recommendation of the Meta-Analysis of Observational Studies in Epidemiology group with prespecified inclusion and exclusion criteria. The DEALE method was used to combine mortality rates, and imputation techniques were used to calculate standard errors. Meta-regression techniques were used to synthesize data. Publication bias was assessed using funnel plots. RESULTS: Of 6,528 citations collected, 20 articles reporting on 1,047 patients were included in the analysis. The median age was 51 years (interquartile range 49-55), with 59 % (54-67) female. The median peritoneal carcinomatosis index score was 19 (16-23). Complete cytoreduction (CC0, 1) was performed in 67 % (46-93 %) of patients. Pooled estimates of survival yielded a 1-, 3- and 5-year survival of 84, 59, and 42 %, respectively. Patients receiving early postoperative intraperitoneal chemotherapy [EPIC] (44 %) and those receiving cisplatin intraperitoneal chemotherapy alone (48 %) or in combination (44 %) had an improved 5-year survival. CONCLUSIONS: While CRS + HIPEC has led to an improved survival for patients with MPM compared to historic data, heterogeneity of studies precludes generalizable inferences. EPIC chemotherapy and cisplatin chemoperfusion may infer survival benefit.
BACKGROUND: Due to the increased adoption of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), patients with malignant peritoneal mesothelioma (MPM) have seen improved outcomes. We aimed to evaluate and synthesize the recent published literature. METHODS: The review was conducted according to the recommendation of the Meta-Analysis of Observational Studies in Epidemiology group with prespecified inclusion and exclusion criteria. The DEALE method was used to combine mortality rates, and imputation techniques were used to calculate standard errors. Meta-regression techniques were used to synthesize data. Publication bias was assessed using funnel plots. RESULTS: Of 6,528 citations collected, 20 articles reporting on 1,047 patients were included in the analysis. The median age was 51 years (interquartile range 49-55), with 59 % (54-67) female. The median peritoneal carcinomatosis index score was 19 (16-23). Complete cytoreduction (CC0, 1) was performed in 67 % (46-93 %) of patients. Pooled estimates of survival yielded a 1-, 3- and 5-year survival of 84, 59, and 42 %, respectively. Patients receiving early postoperative intraperitoneal chemotherapy [EPIC] (44 %) and those receiving cisplatin intraperitoneal chemotherapy alone (48 %) or in combination (44 %) had an improved 5-year survival. CONCLUSIONS: While CRS + HIPEC has led to an improved survival for patients with MPM compared to historic data, heterogeneity of studies precludes generalizable inferences. EPIC chemotherapy and cisplatin chemoperfusion may infer survival benefit.
Authors: Alexandre Ferreira Oliveira; Claudio Almeida Quadros; Héber Salvador de Castro Ribeiro; Alberto Julius Alves Wainstein; Bruno José de Queiroz Sarmento; Jorge Lyra; Glauco Baiocchi Neto; Reitan Ribeiro; Rodrigo Nascimento Pinheiro; Elio José Silveira da Silva Barreto; Jason Park; Andrew McKay; Arnab Gupta; Dhairyasheel Savant; Aviram Nissan; Douglas Zippel; Augusto Leon; Juan Enrique Bargallo-Rocha; Hector Martinez Said; Yuko Kitagawa; Kazuhiro Yoshida; Woo Yong Lee; Do Joong Park; Ashraf Zaghloul; Wael A Gawad; Gong Chen; Haroon Javaid Majid; Muhammad Arshad Cheema; Alessandro Gronchi; Tibor Kovacs; Domenico D'Ugo; David L Bartlett; James R Howe; Chandrakanth Are Journal: Ann Surg Oncol Date: 2021-01-18 Impact factor: 5.344
Authors: David B Chapel; Jefree J Schulte; Gudrun Absenger; Richard Attanoos; Luka Brcic; Kelly J Butnor; Lucian Chirieac; Andrew Churg; Françoise Galateau-Sallé; Kenzo Hiroshima; Yin P Hung; Hedy Kindler; Thomas Krausz; Alberto Marchevsky; Mari Mino-Kenudson; Jeffrey Mueller; Kazuki Nabeshima; Kirin Turaga; Ann E Walts; Aliya N Husain Journal: Mod Pathol Date: 2020-10-15 Impact factor: 7.842