Peritoneal Mesothelioma Surgery

Quick Summary

Peritoneal mesothelioma has the best prognosis of all mesothelioma locations, thanks in large part to an advanced surgical technique used to treat this disease. At any stage, peritoneal mesothelioma patients have surgical options that can improve survival and increase quality of life.

Peritoneal Mesothelioma Surgery Overview

If you’ve been diagnosed with peritoneal mesothelioma, then there are important surgical options available to you.

Here’s what you need to know about peritoneal mesothelioma surgery:

  • Peritoneal mesothelioma can effectively be treated using surgery-based treatment that also includes chemotherapy and radiation therapy
  • Surgeries for peritoneal mesothelioma can be either curative (removing all visible signs of tumors) or palliative (improving quality of life)
  • Curative surgeries are generally performed on early-stage peritoneal mesothelioma patients
  • Palliative surgeries are performed on late-stage peritoneal mesothelioma patients
  • The primary surgery for peritoneal mesothelioma is cytoreduction
  • Mesothelioma specialists across the country are available to treat peritoneal mesothelioma patients with surgical procedures now

Goals of Peritoneal Mesothelioma Surgery

Surgery is just one part of a multimodal treatment approach to peritoneal mesothelioma. The goals of surgical treatment depend on your unique case.

When doctors establish treatment goals they look at factors like:

  • How advanced the disease is
  • The shape and size of the tumor
  • Where the tumor has metastasized
  • The age and health level of the patient

These factors determine the likelihood of being able to remove the tumor surgically or not.

Depending on the unique case, these factors will determine any of the following treatment goals:

  • Remove all visible signs of tumors
  • Remove parts of tumors, leaving behind tumor sections to be treated with other therapies
  • Remove diseased abdominal tissues and organs
  • Stop and prevent metastasis (cancer spreading)
  • Prevent mesothelioma recurrence (when cancer comes back after being eliminated)
  • Alleviate painful symptoms (palliative)

Based on the patient’s case and what the treatment goals are, doctors will either recommend curative surgery or palliative surgery for peritoneal mesothelioma.

Curative Surgeries

Curative surgeries are performed when doctors feel there is a high likelihood of being able to surgically remove and eliminate all visible signs of cancer. However, doctors are careful not to use to the term “cured” because there is still a risk of recurrence, which is what happens when the mesothelioma comes back after having been removed.

Palliative Surgeries

The second type of surgery, palliative surgery, follows a treatment goal of alleviating symptoms. Patients often suffer from peritoneal mesothelioma symptoms such as abdominal pain and bloating caused by fluid buildup in the peritoneum (ascites). During palliative surgeries, doctors drain the fluid buildup from the peritoneum. Other palliative surgeries focus on debulking the tumors as opposed to removing them to help alleviate pain.

Peritoneal Mesothelioma Surgery Options

Surgery Options Update

There are 2 standard surgical procedures for peritoneal mesothelioma. Depending on the case, both surgeries may be performed for one patient. Either of these surgeries can be curative or palliative to help alleviate symptoms.


Cytoreduction

Cytoreduction surgery means to surgically reduce the number of cancer cells.

It is a standard surgery performed on peritoneal mesothelioma patients. It can be done at any stage, depending on the case. However, the goal of cytoreduction surgery will be different for early-stage patients than for late-stage patients.

There are 2 broad types of cytoreduction surgery:

  • Complete Cytoreduction: During cytoreduction surgery for peritoneal mesothelioma, doctors remove tumors from the peritoneum. Complete cytoreduction surgery means that doctors is able to completely remove all visible signs of the tumors. This is typically only possible on early-stage peritoneal mesothelioma patients when the tumors are still relatively localized.
  • Incomplete Cytoreduction: Incomplete cytoreduction surgery happens when doctors know they cannot entirely remove all visible signs of tumors. Typically, this occurs in late-stage patients when the tumors have spread to distant sites. Instead of complete removal, surgeons focus on removing as much as possible to help alleviate pain from metastasis. Removing parts of tumors is also called “debulking” surgery.

Cytoreduction With HIPEC:

Complete cytoreduction surgery is often combined with HIPEC—heated intraperitoneal chemotherapy. Named the “The Sugarbaker Technique” after its developer Dr. Paul Sugarbaker, HIPEC during cytoreduction surgery helps to kill off any remaining microscopic cancer cells after surgery.

Heated chemotherapy drugs are administered directly into the abdominal cavity, bathing the organs in the anti-cancer drugs.

Though controversial at first, this combination procedure has proven to be highly effective in reducing rates of recurrence. Directly administering chemotherapy into the abdomen allows it to work more efficiently than conventional chemotherapy, which is administered into the bloodstream.

Peritonectomy

The second surgical procedure available to peritoneal mesothelioma patients is the peritonectomy. Typically combined with complete cytoreduction surgery, a peritonectomy involves removing the diseased peritoneum (abdominal lining).

Removing the diseased peritoneum, visible tumors around the peritoneum and administering HIPEC is an important surgical approach to preventing recurrence in early-stage and some late-stage peritoneal mesothelioma patients.

Peritoneal Mesothelioma Survival Rates After Surgery

Many studies have been conducted over the years to determine the effectiveness of aggressive procedures like cytoreduction with HIPEC as they relate to long-term survival. Different studies produce different results, as a lot of the outcomes depend on the selection of patients. Age, gender, health level and race all play a role in how the patient will respond to aggressive surgical treatments, which is why there are often mixed findings.

The average life expectancy of peritoneal mesothelioma patients is one year. Different studies show a 38-40% one-year survival rate for patients who don’t undergo cytoreduction surgery.

However, when patients do undergo aggressive surgical procedures, their survival rates significantly increase.

Peritoneal Mesothelioma Update

Looking at a range of studies, peritoneal mesothelioma patients who undergo cytoreduction with HIPEC can survive anywhere from 35 to 60 months. One study found that the 5-year survival rate for peritoneal mesothelioma patients who undergo this procedure is 80%.

Though the exact life expectancy for a patient who undergoes cytoreductive surgery cannot be determined ahead of time, medical advancements in peritoneal mesothelioma surgeries have allowed for patients to significantly improve their survival time.

Seeking Compensation for Peritoneal Mesothelioma Surgeries

If you’ve been diagnosed with peritoneal mesothelioma, then it’s critical to obtain the best treatment possible, including life-extending surgeries. Peritoneal mesothelioma patients have a better chance at longer-term survival today, thanks to advanced procedures like cytoreduction with HIPEC. Even late-stage patients have hope for aggressive surgeries, as there are a few peritoneal mesothelioma specialists who will conduct surgery on patients with advanced cases.

All peritoneal mesothelioma patients must be diagnosed and treated by specialists. General oncologists don’t have the expertise to properly diagnose this disease. Seeking a second or even third opinion from a specialist is critical and could save your life.

Contact Mesothelioma Help Now today to learn more about the top mesothelioma specialists near you. We have dedicated Patient Advocates available to review your case and answer questions about how to receive peritoneal mesothelioma treatments.

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Sources
  1. European Journal of Surgical Oncology, Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/18977109. Accessed on December 27, 2017.
  2. Mayo Clinic, “Cytoreductive surgery and HIPEC offers effective treatment for selected patients with peritoneal carcinomatosis” Retrieved from: https://www.mayoclinic.org/medical-professionals/clinical-updates/cancer/cytoreductive-surgery-hipec-offers-effective-treatment-for-patients-with-peritoneal-carcinomatosis. Accessed on December 27, 2017.
  3. Medscape General Medicine, “Peritoneal Mesothelioma: A Review” Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1994863/. Accessed on December 27, 2017.
  4. Lung Cancer International, “Life Expectancy in Pleural and Peritoneal Mesothelioma” Retrieved from: https://www.hindawi.com/journals/lci/2017/2782590/. Accessed on December 27, 2017.

Last modified: May 7, 2018