Research Spotlight: CRS + HIPEC Improves Survival in Peritoneal Mesothelioma

Abdominal Cancers Alliance
Sep 12
2 min read

Serkan Yaşar MD, Feride Yılmaz MD, Güngör Utkan MD, Efnan Algın MD, Doğan Bayram, MD, Selim Tamam MD, Ömür Berna Çakmak Öksüzoğlu MD, Ayşegül İlhan MD, Efe Cem Erdat MD, Ali Ekrem Ünal MD & Şuayib Yalçın MD

Analysis of Treatment Strategies and Outcomes in Malignant Peritoneal Mesothelioma: Insights From a Multi-Center Study. Ann Surg Oncol 31, 6228–6236 (2024). https://doi.org/10.1245/s10434-024-15506-3 doi:10.1001/jamanetworkopen.2025.2343

Summary:

A new study has shed light on how different treatments affect outcomes for people with malignant peritoneal mesothelioma (MPeM), a rare cancer that forms in the lining of the abdomen. This research aimed to better understand malignant peritoneal mesothelioma. The study focused on how the disease behaves, how it affects patients, and how different treatments work.

Key Study Question

Which treatment strategies lead to better survival outcomes for patients with malignant peritoneal mesothelioma (MPeM), and what patient or disease factors predict those outcomes? More specifically, the researchers wanted to know how do survival rates compare between patients treated with cytoreductive surgery plus heated chemotherapy (the infusion of heated chemotherapy throughout the abdominal cavity) (CRS + HIPEC) versus those treated with chemotherapy alone or no treatment.

The Big Picture

What was done: The researchers looked at medical records from 118 patients treated at five different hospitals. They divided the patients into two main groups:

Group 1: Patients who had surgery to remove as much of the tumor as possible, followed by heated chemotherapy directly into the abdomen (called CRS-HIPEC).
Group 2: Patients whose cancer had spread too much for surgery, so they received chemotherapy instead.

They compared how long patients lived and how well they responded to these treatments.

What They Found

Surgery and heated chemotherapy (CRS-HIPEC): Patients who had this treatment lived longer and had fewer signs of cancer returning compared to those who only had chemotherapy.
Chemotherapy alone: This treatment worked best for patients whose cancer couldn’t be removed by surgery. However, these patients had a shorter life expectancy.
Chemotherapy combination: The combination of platinum-based drugs and pemetrexed -- a type of chemotherapy drug used to treat certain cancers, was effective and safe for patients who couldn’t have surgery.

Why It Matters for Patients

For patients with MPeM, surgery followed by heated chemotherapy offers the best chance for longer survival. For those who can’t have surgery, chemotherapy remains a useful option. These findings help doctors make better treatment decisions and improve care for people with this rare cancer.

Bottom Line

Patients who were able to receive CRS + HIPEC had much longer survival: median overall survival was about 44.6 months (nearly four years), while patients treated with chemotherapy alone (because surgery was not possible) lived on average 11-13 months. The study also found that patients whose surgeons could remove nearly all visible tumor (giving a low “completeness of cytoreduction”) and whose disease was less widespread in the abdomen fared significantly better.