Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for malignant peritoneal mesothelioma: Multi-institutional experience

Tristan D. Yan, Marcello Deraco, Dario Baratti, Shigeki Kusamura, Dominique Elias, Olivier Glehen, François N. Gilly, Edward A. Levine, Perry Shen, Faheez Mohamed, Brendan J. Moran, David L. Morris, Terence C. Chua, Pompiliu Piso, Paul H. Sugarbaker

Research output: Contribution to journalArticlepeer-review

575 Citations (Scopus)


Purpose: This multi-institutional registry study evaluated cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) for diffuse malignant peritoneal mesothelioma (DMPM). Patients and Methods: A multi-institutional data registry that included 405 patients with DMPM treated by a uniform approach that used CRS and HIPEC was established. The primary end point was overall survival. The secondary end point was evaluation of prognostic variables for overall survival. Results: Follow-up was complete in 401 patients (99%). The median follow-up period for the patients who were alive was 33 months (range, 1 to 235 months). The mean age was 50 years (standard deviation [SD], 14 years). Three hundred eighteen patients (79%) had epithelial tumors. Twenty-five patients (6%) had positive lymph nodes. The mean peritoneal cancer index was 20. One hundred eighty-seven patients (46%) had complete or near-complete cytoreduction. Three hundred seventy-two patients (92%) received HIPEC. One hundred twenty-seven patients (31%) had grades 3 to 4 complications. Nine patients (2%) died perioperatively. The mean length of hospital stay was 22 days (SD, 15 days). The overall median survival was 53 months (1 to 235 months), and 3- and 5-year survival rates were 60% and 47%, respectively. Four prognostic factors were independently associated with improved survival in the multivariate analysis: epithelial subtype (P < .001), absence of lymph node metastasis (P < .001), completeness of cytoreduction scores of CC-0 or CC-1 (P < .001), and HIPEC (P = .002). Conclusion: The data suggest that CRS combined with HIPEC achieved prolonged survival in selected patients with DMPM.

Original languageEnglish
Pages (from-to)6237-6242
Number of pages6
JournalJournal of Clinical Oncology
Issue number36
Publication statusPublished - 20 Dec 2009
Externally publishedYes


Dive into the research topics of 'Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for malignant peritoneal mesothelioma: Multi-institutional experience'. Together they form a unique fingerprint.

Cite this