Medical Oncology

, 35:69 | Cite as

The impact of chemotherapy and its timing on survival in malignant peritoneal mesothelioma treated with complete debulking

  • Samer A. Naffouje
  • Kiara A. Tulla
  • George I. Salti
Original Paper


The current standard of treatment for malignant peritoneal mesothelioma (MPM) is cytoreductive surgery when the disease distribution is favorable. The role of chemotherapy, as an adjunct to surgery, remains unclear. The national database of mesothelioma was used to identify MPM patients who were treated with curative intent. Patients were divided into treatment groups: (1) chemotherapy only, (2) surgery only, (3) neoadjuvant chemotherapy + surgery, and (4) surgery + adjuvant chemotherapy. A negative control group of patients who did not receive any treatment was added (group 0). Totally, 1740 patients were included. Mean age was 63.04 ± 14.58 and 60.7% were males. The patients’ distribution into the treatment groups was 604, 684, 169, 55, and 228 patients in groups 0–4, respectively, with a median survival of 3.61 ± 0.37, 11.10 ± 0.73, 57.41 ± 11.91, 52.30 ± 7.20, and 55.00 ± 9.19 months. The addition of chemotherapy, in any setting, to surgery provided an improved survival at 1 year (p = 0.006). This survival benefit ceased at the 2-, 3-, and 5-year checkpoints. The multivariate analysis identified age, sarcomatoid/biphasic histologies, nodal and distant metastasis, and offering no treatment or chemotherapy only as poor prognostic factors for overall survival. No difference in overall survival was noted with the addition of chemotherapy to complete debulking regardless of the timing. Complete debulking remains the standard treatment for MPM. The addition of systemic chemotherapy provides a short-term survival improvement at 1 year only and was similar whether given in the neoadjuvant or adjuvant setting. Nevertheless, it did not add a survival benefit beyond the 1-year time point.


Peritoneal mesothelioma Chemotherapy Adjuvant Neoadjuvant Survival NCDB 


Compliance with ethical standards

Conflict of interest

The authors do not have any personal, institutional, or financial affiliations to disclose. The authors have no conflict of interest to report.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Samer A. Naffouje
    • 1
  • Kiara A. Tulla
    • 1
  • George I. Salti
    • 2
    • 3
  1. 1.Department of General SurgeryUniversity of Illinois Hospital and Health Sciences SystemChicagoUSA
  2. 2.Department of Surgical OncologyEdward Cancer CenterNapervilleUSA
  3. 3.Division of Surgical OncologyUniversity of Illinois Hospital and Health Sciences SystemChicagoUSA

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