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Clinical picture, response to therapy, and survival of women with diffuse malignant peritoneal mesothelioma
Author(s) -
Eltabbakh Gamal H.,
Piver M. Steven,
Hempling Ronald E.,
Recio Fernando O.,
Intengen Marilyn E.
Publication year - 1999
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/(sici)1096-9098(199901)70:1<6::aid-jso2>3.0.co;2-x
Subject(s) - medicine , mesothelioma , peritoneal mesothelioma , oncology , pathology
Background and Objectives The clinical picture, response to therapy, and prognosis of women with diffuse malignant peritoneal mesotheliomas (DMPM) are ill defined. The purpose of this study is to report on the clinical picture, response to therapy, and survival of women with DMPM. Methods The study is a retrospective review of 15 women with the confirmed pathologic diagnosis of DMPM treated between 1964 and 1996. Survival curves were constructed according to the Kaplan‐Meier method. The effect of different factors on survival was studied using the log‐rank test. Two‐tailed P values < 0.05 were considered significant. Results Clinical features included abdominal distension (11/15, 73%), abdominal pain (6/15, 40%), ascites (9/15, 60%), abdominal or pelvic masses (14/15, 93%), elevated CA‐125 (4/4, 100%), thrombocytosis (4/15, 27%), and thrombo‐embolic manifestations (3/15, 20%). The response rate to all first‐line chemotherapy regimens was 30%. The response rate to paclitaxel/cisplatin was 66.7% and the toxicity was tolerable. The median survival of all patients was 12.5 months. Patients who underwent cytoreductive surgery survived longer than those who underwent biopsy only (median survival 13.5 vs. 6.0 months, P = 0.24). Patients who received chemotherapy survived significantly longer than those who did not receive chemotherapy (29.0 vs. 1.0 months, P = 0.03). Patients who responded to first‐line chemotherapy survived significantly longer than those who did not respond ( P = 0.04). Conclusions Cytoreductive surgery and chemotherapy, especially with paclitaxel and cisplatin, might be of benefit in women with DMPM. J. Surg. Oncol. 1999;70:6–12. © 1999 Wiley‐Liss, Inc.