Malign Peritoneal Mezotelyoma Hastalarının Retrospektif Değerlendirilmesi

Öz

ilişkilendirilmiştir. Malign peritoneal mezotelyoma (MPM) plevral tutulumdan sonra ikinci sıklıkta görülür. Çalışmamızda MPM tanısı alan hastalarda demografik özelliklerin, kullanılan tedavi seçeneklerinin incelenmesi amaçlandı. Çalışmamızda 12 erkek, 4 kadın toplamda 16 hastanın medyan yaşı 66 (46-93) yıldı. 15 hasta epiteolid, 1 hasta bifazik histopatolojiye sahipti. 2 hastaya hipertermik intraperitoneal kemoterapi (HİPEK) yapılmıştı. Birinci seçim kemoterapi alan 16 hasta, ikinci seçim kemoterapi alan 13 hasta, üçüncü seçim kemoterapi alan 4 hasta, dördüncü seçim kemoterapi alan 1 hasta mevcuttu. Birinci seçim kemoterapi alan hastaların medyan progresyonsuz sağkalımı 14,4 ay (CI %95 7,4:21,4) saptandı. Hastaların medyan toplam sağkalımı 22,0 aydı (CI %95 16:27,9). Standart tedavi seçenekleri arasında olan sitoredüksiyon cerrahisi + HİPEK, sistemik kemoterapi ve immünoterapinin optimal kullanımı ve bu tedavilere uygun hasta seçimi için prospektif, multidispliner, daha fazla hasta sayısı içeren çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• Peritoneal,Mezotelyoma,Hipertermik İntraperitoneal Kemoterapi,Sitoredüksiyon Cerrahisi,Sistemik kemoterapi

Retrospective Evaluation of Malignant Peritoneal Mesothelioma Patients

Öz

Malignant mesothelioma is a neoplasm that originates from the serosal membrane of pleura, peritoneum, pericardium, and tunica vaginalis. It has been particularly associated with exposure to asbestos. Malignant peritoneal mesothelioma (MPM) is the second most commonly encountered type of mesothelioma after pleura. In our study, we aimed to analyze the demographic characteristics and treatment options of the patients diagnosed with MPM. In our study, the median age of 16 patients (12 men and four women) was 66 (46-93) years. Fifteen patients had epithelioid, and one patient had biphasic histopathology. Hyperthermic intraperitoneal chemotherapy (HIPEC) was performed in 2 patients. There were 16 patients receiving first-line chemotherapy, 13 patients receiving second-line chemotherapy, four patients receiving third-line chemotherapy, and one patient receiving fourth-line chemotherapy. The median progression-free survival of patients receiving first-line chemotherapy was found 14.4 months (CI 95% 7.4: 21.4). The median overall survival of the patients was detected 22. months (CI 95% 16: 27.9%). In order to determine which group of patients will benefit from cytoreduction surgery+HIPEC or which group of patients should start with systemic chemotherapy or immunotherapy, there is a need for prospective, multidisciplinary studies and a more significant number of patients.

Anahtar Kelimeler

• Peritoneal,Mesothelioma,Hyperthermic intraperitoneal chemotherapy,Cytoreduction Surgery,Systemic Chemotherapy

Kaynakça

1. 1. Bridda A, Padoan I, Mencarelli R, et al. Peritoneal mesothelioma: a review. MedGenMed 2007;9:32.
2. 2. Letica Kriegel AS, Leinwand JC, Sonett JR, Gorenstein LA, Taub RN, Chabot JA, Kluger MD. 50 Patients with Malignant Mesothelioma of Both the Pleura and Peritoneum: A Single-Institution Experience. Ann Surg Oncol. 2020;27:205-213.
3. 3. Leinwand JC, Chabot JA, Kluger MD. Preventing recurrence of diffuse malignant peritoneal mesothelioma. Expert Rev Anticancer Ther. 2016;16:989-95.
4. 4. van Zandwijk N, Clarke C, Henderson D, et al. Guidelines for the diagnosis and treatment of malignant pleural mesothelioma. J Thorac Dis. 2013;5:254-307.
5. 5. Wong J, Koch AL, Deneve JL, et al. Repeat cytoreductive surgery and heated intraperitoneal chemotherapy may offer survival benefit for intraperitoneal mesothelioma: a single institution experience. Ann Surg Oncol. 2014;21:1480-6.
6. 6. Antman KH, Pomfret EA, Aisner J, et al. Peritoneal mesothelioma: natural history and response to chemotherapy. J Clin Oncol 1983;1:386.
7. 7. Kaya H, Sezgı C, Tanrıkulu AC, et al. Prognostic factors influencing survival in 35 patients with malignant peritoneal mesothelioma. Neoplasma 2014;61:433.
8. 8. Ceelen WP, Påhlman L, Mahteme H. Pharmacodynamic aspects of intraperitoneal cytotoxic therapy. Cancer Treat Res 2007;134:195.

9. 9. Passot G, Vaudoyer D, Villeneuve L, et al. What made hyperthermic intraperitoneal chemotherapy an effective curative treatment for peritoneal surface malignancy: A 25-year experience with 1,125 procedures. J Surg Oncol 2016;113:796.
10. 10. Sugarbaker PH, Graves T, DeBruijn EA, et al. Early postoperative intraperitoneal chemotherapy as an adjuvant therapy to surgery for peritoneal carcinomatosis from gastrointestinal cancer: pharmacological studies. Cancer Res. 1990;50:5790-4.
11. 11. Yan TD, Links M, Fransi S, et al. Learning curve for cytoreductive surgery and perioperative intraperitoneal chemotherapy for peritoneal surface malignancy--a journey to becoming a Nationally Funded Peritonectomy Center. Ann Surg Oncol 2007;14:2270.
12. 12. Gusani NJ, Cho SW, Colovos C, et al. Aggressive surgical management of peritoneal carcinomatosis with low mortality in a high-volume tertiary cancer center. Ann Surg Oncol 2008;15:754.
13. 13. Jin S, Cao S, Cao J, et al. Predictive factors analysis for malignant peritoneal mesothelioma. J Gastrointest Surg 2015;19:319.
14. 14. Cao C, Yan TD, Deraco M, et al. Importance of gender in diffuse malignant peritoneal mesothelioma. Ann Oncol 2012;23:1494.
15. 15. Blackham AU, Shen P, Stewart JH, et al. Cytoreductive surgery with intraperitoneal hyperthermic chemotherapy for malignant peritoneal mesothelioma: mitomycin versus cisplatin. Ann Surg Oncol 2010;17:2720.
16. 16. Alexander HR Jr, Bartlett DL, Pingpank JF, et al. Treatment factors associated with long-term survival after cytoreductive surgery and regional chemotherapy for patients with malignant peritoneal mesothelioma. Surgery 2013;153:779.
17. 17. Yan TD, Deraco M, Baratti D, et al. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for malignant peritoneal mesothelioma: multi-institutional experience. J Clin Oncol 2009;27:6237.
18. 18. Jänne PA, Wozniak AJ, Belani CP, et al. Open-label study of pemetrexed alone or in combination with cisplatin for the treatment of patients with peritoneal mesothelioma: outcomes of an expanded access program. Clin Lung Cancer 2005; 7:40.
19. 19. Carteni G, Manegold C, Garcia GM, et al. Malignant peritoneal mesothelioma-Results from the International Expanded Access Program using pemetrexed alone or in combination with a platinum agent. Lung Cancer 2009;64:211.
20. 20. Vogelzang NJ, Rusthoven JJ, Symanowski J, et al. Phase III study of pemetrexed in combination with cisplatin versus cisplatin alone in patients with malignant pleural mesothelioma. J Clin Oncol 2003;21:2636-44.
21. 21. Carteni G, Manegold C, Garcia GM, et al. Malignant peritoneal mesothelioma-Results from the International Expanded Access Program using pemetrexed alone or in combination with a platinum agent. Lung Cancer 2009;64:211.
22. 22. Maio M, Scherpereel A, Calabrò L, et al. Tremelimumab as second-line or third-line treatment in relapsed malignant mesothelioma (DETERMINE): a multicentre, international, randomised, double-blind, placebo-controlled phase 2b trial. Lancet Oncol. 2017;18:1261-73.
23. 23. Hassan R, Thomas A, Nemunaitis JJ, et al. Efficacy and Safety of Avelumab Treatment in Patients With Advanced Unresectable Mesothelioma:Phase 1b Results From the JAVELIN Solid Tumor Trial. JAMA Oncol 2019;5:351-57.
24. 24. Desai A, Karrison T, Rose B, et al. Phase II Trial of Pembrolizumab (NCT02399371) In Previously-Treated Malignant Mesothelioma (MM): Final Analysis (abstract OA08.03). J Thorac Oncol 2018;13:S339.
25. 25. Desai A, Karrison T, Rose B, et al. OA08.03 Phase II Trial of Pembrolizumab (NCT02399371) In Previously-Treated Malignant Mesothelioma (MM): Final Analysis. J Thorac Oncol 2018;13:S339.