Early HIPEC surgery for mesothelioma prolongs patient survival

Research and clinical studies

reading time: 4 minutes

Release date: 08.12.2022

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To cite the Asbestos.com article


Povtak, T. (2022, December 8). Study: HIPEC Surgery for Early Mesothelioma Extends Survival. asbestos.com. Retrieved December 8, 2022 from https://www.asbestos.com/news/2022/12/08/mesothelioma-hipec-surgery-survival/

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Povtak, Tim. “Study: HIPEC Surgery in Early Mesothelioma Extends Survival.” asbestos.com8 Dec 2022, https://www.asbestos.com/news/2022/12/08/mesothelioma-hipec-surgery-survival/.


Povtak, Tim. “Study: HIPEC Surgery in Early Mesothelioma Extends Survival.” asbestos.com. Last modified December 8, 2022. https://www.asbestos.com/news/2022/12/08/mesothelioma-hipec-surgery-survival/.

Earlier is better when it comes to aggressively treating peritoneal mesothelioma cancer with a combination of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.

The wait could cost a patient months of survival. Refusing surgery could cost her years.

The Journal of Gastrointestinal Surgery published a study in November that showed for the first time the extent to which delayed or no mesothelioma surgery can affect patients’ overall survival.

The results of the mesothelioma study were presented earlier this year at the annual meeting of the Society for Surgery of the Alimentary Tract in San Diego.

Surgeons and oncologists from the Abramson Cancer Center at the University of Pennsylvania, Sidney Kimmel Medical College in Philadelphia and the University of Colorado Hospital in Aurora co-authored the study.

“These results underscore the important role that timely surgery can play in patients with peritoneal mesothelioma,” said surgical oncologist and co-author Dr. Giorgos Karakousis of the Abramson Cancer Center versus the Mesothelioma Center on Asbestos.com.

Mesothelioma life expectancy increases with surgery

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy, also known as CRS-HIPEC, has become an effective treatment of choice for mesothelioma specialists in recent years.

This latest life expectancy simulator examined 1,000 cases of peritoneal mesothelioma in three different categories: timely treatment (less than four weeks after diagnosis), delayed treatment (4-24 weeks after diagnosis), and no treatment.

Based on the analysis results, the average life expectancy from the time of diagnosis was:

Timely (less than 4 weeks from diagnosis) 5.24 years
Late (4-12 weeks) 4.8 years
Late (13-24 weeks) 4.37 years
No treatment 2.11 years

Despite the differences in life expectancy, the authors estimate that three out of five patients who are potential candidates for the combination do not receive it. They cited limited access to mesothelioma specialists or oncologists who do not yet know enough about the benefits and eligibility qualifications to recommend it.

“Patients with a new diagnosis of peritoneal mesothelioma should seek early referral to a center with specialized expertise,” Karakousis said.

Mesothelioma specialists are crucial

Peritoneal mesothelioma is a rare cancer caused by ingestion or inhalation of toxic asbestos fibers. It starts in the thin layer of tissue that lines the abdomen, but it can take decades for obvious symptoms to appear.

The majority of oncologists in the US rarely see cases of mesothelioma. The study emphasized the importance of finding a mesothelioma specialist center for optimal care.

Peritoneal mesothelioma is considered more treatable than pleural mesothelioma, which develops around the lungs and has a shorter median survival time. There is no definitive cure for either type of mesothelioma.

Accurate diagnosis is difficult, which often contributes to the delay in finding an effective mesothelioma treatment. Early symptoms are often the same as other abdominal problems, including fatigue, fever, loss of appetite, nausea, and abdominal pain.

The majority of patients diagnosed with mesothelioma are treated with only standard chemotherapy, followed by palliative care.

Elimination of missed treatment opportunities

The CRS-HIPEC process is complex and can take up to 12 hours. Lengthy, detailed mesothelioma surgery attempts to remove any visible cancerous cells that can spread throughout the abdomen and affect numerous organs.

HIPEC, which immediately follows cytoreductive surgery, involves circulation of heated chemotherapy through the abdominal cavity. The intent is to kill any microscopic tumor cells that eluded the surgeon. The chemotherapy circulates for up to 90 minutes before being drained.

The authors of the most recent study concluded that opportunities to maximize survival in peritoneal mesothelioma continue to be missed and offered this study to educate patients and clinicians.

“To date, there have been no randomized controlled trials examining the surgical management of MPM [malignant pleural mesothelioma]and where such studies do not exist, [this] Model may be of use to clinicians,” the study concluded.

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