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Annals of Surgical Oncology

, Volume 26, Issue 3, pp 852–860 | Cite as

Well-Differentiated Papillary Mesothelioma of the Peritoneum: A Retrospective Study from the RENAPE Observational Registry

  • Guillaume VoginEmail author
  • Liza Hettal
  • Jean-Michel Vignaud
  • Peggy Dartigues
  • Diane Goere
  • Gwenaël Ferron
  • Bruno Heyd
  • Jean-Marc Bereder
  • Jean-Jacques Tuech
  • Olivier Glehen
  • Cécile de Chaisemartin
  • Yoann Lherm
  • Laurent Villeneuve
  • Vahan Kepenekian
  • Frédéric Marchal
  • the RENAPE Network
Peritoneal Surface Malignancy

Abstract

Background

Well-differentiated papillary mesothelioma of the peritoneum (WDPMP) is a rare entity. Questions regarding management are still being debated as no more than 50 cases have been reported in the literature.

Objective

We aimed to analyze the clinical, therapeutic, and prognostic data of patients with WDPMP from the RENAPE observational registry.

Patients and Methods

All patients diagnosed with WDPMP and prospectively included in the RENAPE national registry between 2010 and 2018 were also included in our study. Expert pathologists from the RENA-PATH group confirmed all cases. All clinical, therapeutic, postoperative, and prognostic data were extracted and analyzed.

Results

We report on 56 patients with a mean age of 52 years (range 21–74). WDPMP was incidentally diagnosed during imaging or surgery in 16% and 36% of patients, respectively, and an association with synchronous malignancy was found in 18% of patients. Nine lesions showed discrete signs of fatty invasion. The median Peritoneal Cancer Index was 11 (range 0–33). Eleven patients were treated with definitive excision, 4 were treated with cytoreductive surgery (CRS) only, 37 were treated with CRS and hyperthermic intraperitoneal chemotherapy (HIPEC), and 2 were treated with CRS plus HIPEC plus early postoperative intraperitoneal chemotherapy. CRS was considered to be complete in 90% of cases. One patient died postoperatively and 16 patients (31%) faced postoperative complications. The median disease-free survival was 144 months; Four patients relapsed, with a median period of 27 months. No prognostic factors could be identified.

Conclusions

Our analysis confirms the favorable prognosis of WDPMP. CRS and HIPEC could be a therapeutic option for diffuse, symptomatic, and/or recurrent disease.

Notes

Acknowledgment

The collaborators of the RENAPE Network include: Julio Abba, MD (Department of Digestive Surgery, Grenoble University Hospital, Grenoble, France); Karine Abboud, MD (Department of General Surgery, CHU Hospital, Jean Monnet University, Saint Étienne, France); Mohammad Alyami, MD (Department of Digestive Surgery, Lyon-Sud University Hospital, Lyon, France); Catherine Arvieux, MD, PhD (Department of Digestive Surgery, Grenoble University Hospital, Grenoble, France); Gerlinde Averous, MD (Department of Pathology, Hautepierre University Hospital, Strasbourg, France); Naoual Bakrin, MD, PhD (Department of Digestive Surgery, Lyon-Sud University Hospital, Lyon, France); Houda Ben Rejeb, MD (Department of Pathology, Bergonie Institute, Bordeaux, France); Nazim Benzerdjeb, MD, PhD (Department of Pathology, Lyon-Sud University Hospital, Lyon, France); Isabelle Berton-Rigaud (Department of Digestive Oncology, ICO René Gauducheau Cancer Center, Saint-Herblain, France); Frédéric Bibeau, MD, PhD (Department of Pathology, Côte de Nacre University Hospital, Caen, France); Isabelle Bonnefoy (Department of Digestive Surgery, Lyon-Sud University Hospital, Lyon, France); Dominique Bouzard, MD (Department of Surgery, Louis Mourier University Hospital, Colombes, France); Cécile Brigand, MD, PhD (Department of Digestive Surgery, Hautepierre University Hospital, Strasbourg, France); Sébastien Carrère, MD (Department of Surgical Oncology, Val d’Aurelle Montpellier Cancer Center, Montpellier, France); Anne Chevallier, MD (Department of Pathology, Archet 2 University Hospital, Nice, France); Virginie Cloud (Department of Digestive Surgery, Lyon-Sud University Hospital, Lyon, France); Thomas Courvoisier, MD (Department of Digestive Surgery, Poitiers University Hospital, Poitiers, France); Jean-Baptiste Delhorme, MD, PhD (Department of Digestive Surgery, Hautepierre University Hospital, Strasbourg, France); Anthony Dohan, MD, PhD (Department of Radiology, Lariboisière University Hospital, Paris, France); Frédéric Dumont (Department of Surgical Oncology, ICO René Gauducheau Cancer Center, Saint-Herblain, France); Clarisse Eveno, MD, PhD (Surgical Oncologic and Digestive Unit, Lariboisière University Hospital, Paris, France); Juliette Fontaine, MD (Department of Pathology, Lyon-Sud University Hospital, Lyon, France); Johan Gagniere, MD (Department of Digestive Surgery, Estaing University Hospital, Clermont-Ferrand, France); Laurent Ghouti, MD (Department of Digestive Surgery, Purpan University Hospital, Toulouse, France); François-Noël Gilly, MD, PhD (Department of Digestive Surgery, Centre Hospitalier Lyon Sud, Pierre-Bénite, France); Laurence Gladieff, MD (Department of Medical Oncology, Claudius Regaud Institute IUTC, Toulouse, France); Jean-Marc Guilloit, MD (Department of Surgical Oncology, Francois Baclesse Comprehensive Cancer Center, Caen, France); Frédéric Guyon, MD (Department of Surgical Oncology, Bergonie Institute, Bordeaux, France); Sylvie Isaac, MD (Department of Pathology, Centre Hospitalier Lyon Sud, Pierre-Bénite, France, France); Peggy Jourdan-Enfer (Department of Digestive Surgery, Lyon-Sud University Hospital, Lyon, France); Rachid Kaci, MD (Department of Pathology, Lariboisière University Hospital, Paris, France); Reza Kianmanesh (Department of Digestive Surgery, Robert Debré University Hospital, Reims, France); Marie-Hélène Laverrière, MD (Department of Pathology, Grenoble University Hospital, Grenoble, France); Bernard Lelong, MD (Department of Surgical Oncology, Paoli Calmettes Institute, Marseille, France); Agnès Leroux-Broussier, MD (Department of Pathology, Lorraine Institute of Oncology, Vandoeuvre-les-Nancy, France); Réa Lo Dico, MD, PhD (Surgical Oncologic and Digestive Unit, Lariboisière University Hospital, Paris, France); Gérard Lorimier, MD (Department of Digestive Surgery, Angers University Hospital, Angers, France); Pascale Mariani, MD (Department of Surgical Oncology, Curie Institute, Paris, France); Emilie Mathiotte (Hospices Civils de Lyon, Pôle de Santé Publique, Unité de Recherche Clinique, Lyon, France); Pierre Meeus, MD (Department of Surgery, Léon Bérard Comprehensive Cancer Center, Lyon, France); Eliane Mery, MD (Department of Pathology, Claudius Regaud Institute IUTC, Toulouse, France); Simon Msika, MD, PhD (Department of Surgery, Louis Mourier University Hospital, Colombes, France); Cédric Nadeau, MD (Gynaecology and Obstetrics Ward, Mother and Child Pole, Poitiers University Hospital, University of Poitiers, Poitiers, France); Pablo Ortega-Deballon, MD, PhD (Department of Digestive Surgical Oncology, University Hospital of Dijon, Dijon, France); Brice Paquette, MD (Department of Digestive Surgery, Minjoz University Hospital, Besançon, France); Guillaume Passot, MD, PhD, (Department of Digestive Surgery, Lyon-Sud University Hospital, Lyon, France); Olivier Pellet, MD (INOLA, Lyon, France); Patrice Peyrat, MD (Department of Surgery, Léon Bérard Comprehensive Cancer Center, Lyon, France); Denis Pezet, MD, PhD (Department of Digestive Surgery, Estaing University Hospital, Clermont-Ferrand, France); Nicolas Pirro, MD, PhD (Department of Digestive Surgery, Timône University Hospital, Marseille, France); Marc Pocard, MD, PhD (Surgical Oncologic and Digestive Unit, Lariboisière University Hospital, Paris, France); Flora Poizat, MD (Department of Pathology, Paoli Calmettes Institute, Marseille, France); Jack Porcheron, MD, PhD (Department of Digestive Surgery, St Etienne University Hospital, St Etienne, France); François Quenet, MD (Department of Digestive Surgical Oncology, Montpellier Cancer Institute, Montpellier, France); Patrick Rat, MD, PhD (Department of Digestive Surgical Oncology, University Hospital of Dijon, Dijon, France); Pierre Rousselot, MD (Department of Pathology, Francois Baclesse Comprehensive Cancer Center, Caen, France); Pascal Rousset, MD, PhD, (Department of Radiology, Centre Hospitalier Lyon Sud, Pierre-Bénite, France); Hélène Senellart (Department of Medical Oncology, ICO René Gauducheau Cancer Center, Saint-Herblain, France); Martine Serrano (Department of Digestive Surgery, Lyon-Sud University Hospital, Lyon, France); Olivia Sgarbura, MD (Department of Surgical Oncology, Val d’Aurelle Montpellier Cancer Center, Montpellier, France); Magali Svrcek, MD, PhD (Department of Pathology, Hospital Saint-Antoine AP-HP, Paris, France); Emilie Thibaudeau, MD (Department of Surgical Oncology, ICO René Gauducheau Cancer Center, Saint-Herblain, France); Yann Touchefeu (Department of Gastroenterology, Nantes University Hospital, Nantes, France); Séverine Valmary-Degano, MD, PhD (Department of Pathology, Minjoz University Hospital, Besançon, France); Delphine Vaudoyer, MD (Department of Digestive Surgery, Lyon-Sud University Hospital, Lyon, France); Véronique Verriele-Beurrier, MD (Department of Pathology, ICO Paul Papin Cancer Center, Angers, France); Romuald Wernert, MD (Department of Surgical Oncology, ICO Paul Papin Cancer Center, Angers, France); Franck Zinzindohoue, MD, PhD (Department of Digestive and General Surgery, G. Pompidou European Hospital, Paris, France).

Author Contributions

Guillaume Vogin: Original draft, writing, and data interpretation. Liza Hettal: Data analysis and interpretation, review and editing. Jean-Michel Vignaud: Review and editing (pathology). Peggy Dartigues: Data acquisition, review and editing. Diane Goere: Data acquisition, review and editing. Gwenaël Ferron: Data acquisition, review and editing. Bruno Heyd: Data acquisition, review and editing. Jean-Marc Bereder: Data acquisition, review and editing. Jean-Jacques Tuech: Data acquisition, review and editing. Vahan Kepenekian: Data acquisition, review and editing. Cécile de Chaisemartin: Data acquisition, review and editing. Yoann Lherm: Data management, quality control of data, review and editing. Laurent Villeneuve: Project administration, review and editing. Olivier Glehen: Funding acquisition, review and editing. Frédéric Marchal: Study design, review and editing.

Funding

RENAPE is funded by the French National Cancer Institute (INCa).

DISCLOSURE

There is no conflict of interest to disclose from any authors.

References

  1. 1.
    Boffetta P. Epidemiology of peritoneal mesothelioma: a review. Ann Oncol. 2007;18(6):985–90.CrossRefGoogle Scholar
  2. 2.
    de Pangher Manzini V. Malignant peritoneal mesothelioma. Tumori. 2005;91(1):1–5.Google Scholar
  3. 3.
    Baratti D, Kusamura S, Cabras AD, Bertulli R, Hutanu I, Deraco M. Diffuse malignant peritoneal mesothelioma: long-term survival with complete cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy (HIPEC). Eur J Cancer. 2013;49(15):3140–8.CrossRefGoogle Scholar
  4. 4.
    Hejmadi R, Ganesan R, Kamal NG. Malignant transformation of a well-differentiated peritoneal papillary mesothelioma. Acta Cytol. 2003;47(3):517–8.Google Scholar
  5. 5.
    Burrig KF, Pfitzer P, Hort W. Well-differentiated papillary mesothelioma of the peritoneum: a borderline mesothelioma. Report of two cases and review of literature. Virchows Arch A Pathol Anat Histopathol. 1990;417(5):443–7.Google Scholar
  6. 6.
    Malpica A, Sant’Ambrogio S, Deavers MT, Silva EG. Well-differentiated papillary mesothelioma of the female peritoneum: a clinicopathologic study of 26 cases. Am J Surg Pathol. 2012;36(1):117–27.CrossRefGoogle Scholar
  7. 7.
    Shinozaki-Ushiku A, Ushiku T, Morita S, Anraku M, Nakajima J, Fukayama M. Diagnostic utility of BAP1 and EZH2 expression in malignant mesothelioma. Histopathology. 2017;70(5):722–33.CrossRefGoogle Scholar
  8. 8.
    Stevers M, Rabban JT, Garg K, Van Ziffle J, Onodera C, Grenert JP, et al. Well-differentiated papillary mesothelioma of the peritoneum is genetically defined by mutually exclusive mutations in TRAF7 and CDC42. Mod Pathol. 2019;32(1):88–99.CrossRefGoogle Scholar
  9. 9.
    Lee YK, Jun HJ, Nahm JH, Lim TS, Park JS, Ahn JB, et al. Therapeutic strategies for well-differentiated papillary mesothelioma of the peritoneum. Jpn J Clin Oncol. 2013;43(10):996–1003.CrossRefGoogle Scholar
  10. 10.
    Bazine A, Fetohi M, Namad T, Benzekri A, Zainoun B, Tanz R, et al. A case of well-differentiated papillary mesothelioma of the male peritoneum: successful treatment by systemic chemotherapy. Cureus. 2017;9(3):e1104.Google Scholar
  11. 11.
    Baratti D, Kusamura S, Nonaka D, Oliva GD, Laterza B, Deraco M. Multicystic and well-differentiated papillary peritoneal mesothelioma treated by surgical cytoreduction and hyperthermic intra-peritoneal chemotherapy (HIPEC). Ann Surg Oncol. 2007;14(10):2790–7.CrossRefGoogle Scholar
  12. 12.
    Villeneuve L, Isaac S, Glehen O, Capovilla M, Chevallier A, Croce S, et al. The RENAPE network: towards a new healthcare organization for the treatment of rare tumors of the peritoneum. Description of the network and role of the pathologists [in French]. Ann Pathol. 2014;34(1):4–8.Google Scholar
  13. 13.
    Villeneuve L, Passot G, Glehen O, Isaac S, Bibeau F, Rousset P, et al. The RENAPE observational registry: rationale and framework of the rare peritoneal tumors French patient registry. Orphanet J Rare Dis. 2017;12(1):37.CrossRefGoogle Scholar
  14. 14.
    Galateau-Salle F, Gilg Soit Ilg A, Le Stang N, Brochard P, Pairon JC, Astoul P, et al. The French mesothelioma network from 1998 to 2013 [in French]. Ann Pathol. 2014;34(1):51–63.Google Scholar
  15. 15.
    Sugarbaker PH. Peritonectomy procedures. Cancer Treat Res. 2007;134:247–64.Google Scholar
  16. 16.
    Sugarbaker PH. Peritonectomy procedures. Surg Oncol Clin North Am. 2003;12(3):703–27, xiii.Google Scholar
  17. 17.
    Sugarbaker PH. Peritonectomy procedures. Cancer Treat Res. 1996;82:235–53.CrossRefGoogle Scholar
  18. 18.
    Sugarbaker PH. Peritonectomy procedures. Ann Surg. 1995;221(1):29–42.CrossRefGoogle Scholar
  19. 19.
    Jacquet P, Sugarbaker PH. Clinical research methodologies in diagnosis and staging of patients with peritoneal carcinomatosis. In: Sugarbaker PH, editor. Peritoneal carcinomatosis: principles of management. Cancer treatment and research, EJ Freireich Series editors. Boston: Kluwer Academic Publishers; 1996. p. 359–74.Google Scholar
  20. 20.
    Sugarbaker PH. Management of peritoneal-surface malignancy: the surgeon’s role. Langenbecks Arch Surg. 1999;384(6):576–87.CrossRefGoogle Scholar
  21. 21.
    Brigand C, Monneuse O, Mohamed F, Sayag-Beaujard AC, Isaac S, Gilly FN, et al. Peritoneal mesothelioma treated by cytoreductive surgery and intraperitoneal hyperthermic chemotherapy: results of a prospective study. Ann Surg Oncol. 2006;13(3):405–12.CrossRefGoogle Scholar
  22. 22.
    Yan TD, Welch L, Black D, Sugarbaker PH. A systematic review on the efficacy of cytoreductive surgery combined with perioperative intraperitoneal chemotherapy for diffuse malignancy peritoneal mesothelioma. Ann Oncol. 2007;18(5):827–34.CrossRefGoogle Scholar
  23. 23.
    Kepenekian V, Elias D, Passot G, Mery E, Goere D, Delroeux D, et al. Diffuse malignant peritoneal mesothelioma: evaluation of systemic chemotherapy with comprehensive treatment through the RENAPE Database: Multi-Institutional Retrospective Study. Eur J Cancer. 2016;65:69–79.CrossRefGoogle Scholar
  24. 24.
    National Cancer Institute PROCSG. Common Terminology Criteria for Adverse Events (CTCAE) Version 4.0 2010 [updated 14 June 2010]. http://evs.nci.nih.gov/ftp1/CTCAE/About.html.
  25. 25.
    R Core Team. R: A language and environment for statistical computing. Vienna: R Foundation for Statistical Computing; 2018.Google Scholar
  26. 26.
    Nasit JG, Dhruva G. Well-differentiated papillary mesothelioma of the peritoneum: a diagnostic dilemma on fine-needle aspiration cytology. Am J Clin Pathol. 2014;142(2):233–42.CrossRefGoogle Scholar
  27. 27.
    Butnor KJ, Sporn TA, Hammar SP, Roggli VL. Well-differentiated papillary mesothelioma. Am J Surg Pathol. 2001;25(10):1304–9.CrossRefGoogle Scholar
  28. 28.
    Daya D, McCaughey WT. Well-differentiated papillary mesothelioma of the peritoneum. A clinicopathologic study of 22 cases. Cancer. 1990;65(2):292–6.Google Scholar
  29. 29.
    Deraco M, Nizri E, Glehen O, Baratti D, Tuech JJ, Bereder JM, et al. Well differentiated papillary peritoneal mesothelioma treated by cytoreduction and hyperthermic intraperitoneal chemotherapy-the experience of the PSOGI registry. Eur J Surg Oncol.  https://doi.org/10.1016/j.ejso.2018.10.065
  30. 30.
    Churg A, Allen T, Borczuk AC, Cagle PT, Galateau-Salle F, Hwang H, et al. Well-differentiated papillary mesothelioma with invasive foci. Am J Surg Pathol. 2014;38(7):990–8.CrossRefGoogle Scholar
  31. 31.
    Washimi K, Yokose T, Amitani Y, Nakamura M, Osanai S, Noda H, et al. Well-differentiated papillary mesothelioma, possibly giving rise to diffuse malignant mesothelioma: a case report. Pathol Int. 2013;63(4):220–5.CrossRefGoogle Scholar
  32. 32.
    Jatzko GR, Jester J. Simultaneous occurrence of a rectal carcinoma and a diffuse well differentiated papillary mesothelioma of the peritoneum. Int J Colorectal Dis. 1997;12(6):326–8.CrossRefGoogle Scholar
  33. 33.
    Gill SE, Ruple SM, Wolff CM, Puls LE. Simultaneous occurrence of well differentiated papillary mesothelioma and endometrioid ovarian cancer: a case report. Gynecol Oncol Case Rep. 2013;4:53–5.CrossRefGoogle Scholar
  34. 34.
    Rathi V, Hyde S, Newman M. Well-differentiated papillary mesothelioma in association with endometrial carcinoma: a case report. Acta Cytol. 2010;54(5 Suppl):793–7.Google Scholar
  35. 35.
    Irwin GW, Ervine A, Kennedy JA. Well-differentiated papillary mesothelioma: peritoneal implants are not always metastases in the presence of cancer. Scott Med J. 2014;59(1):e18–21.CrossRefGoogle Scholar
  36. 36.
    Erkanli S, Kilicdag EB, Bolat F, Kayaselcuk F, Bagis T, Haberal A, et al. Well-differentiated papillary mesothelioma complicating endometrial carcinoma: a case report. Eur J Gynaecol Oncol. 2004;25(3):394–6.Google Scholar
  37. 37.
    Chen X, Sheng W, Wang J. Well-differentiated papillary mesothelioma: a clinicopathological and immunohistochemical study of 18 cases with additional observation. Histopathology. 2013;62(5):805–13.CrossRefGoogle Scholar
  38. 38.
    Hoekstra AV, Riben MW, Frumovitz M, Liu J, Ramirez PT. Well-differentiated papillary mesothelioma of the peritoneum: a pathological analysis and review of the literature. Gynecol Oncol. 2005;98(1):161–7.CrossRefGoogle Scholar

Copyright information

© Society of Surgical Oncology 2019

Authors and Affiliations

  • Guillaume Vogin
    • 1
    • 2
    Email author
  • Liza Hettal
    • 2
  • Jean-Michel Vignaud
    • 3
  • Peggy Dartigues
    • 4
  • Diane Goere
    • 5
  • Gwenaël Ferron
    • 6
  • Bruno Heyd
    • 7
  • Jean-Marc Bereder
    • 8
  • Jean-Jacques Tuech
    • 9
  • Olivier Glehen
    • 10
    • 12
    • 14
  • Cécile de Chaisemartin
    • 11
  • Yoann Lherm
    • 12
    • 13
  • Laurent Villeneuve
    • 12
    • 13
    • 14
  • Vahan Kepenekian
    • 10
  • Frédéric Marchal
    • 15
    • 16
  • the RENAPE Network
  1. 1.Department of Radiation OncologyInstitut de Cancérologie de LorraineVandoeuvre-les-NancyFrance
  2. 2.UMR 7365 CNRS-Université de LorraineIMoPAVandoeuvre-les-NancyFrance
  3. 3.Department of PathologyCentre Hospitalier Universitaire de NancyVandoeuvre-les-NancyFrance
  4. 4.Department of PathologyGustave Roussy InstituteVillejuifFrance
  5. 5.Department of SurgeryGustave Roussy InstituteVillejuifFrance
  6. 6.Department of Surgical OncologyInstitut Universitaire du Cancer de Toulouse – OncopoleToulouseFrance
  7. 7.Department of Surgical OncologyJean Minjoz University HospitalBesançonFrance
  8. 8.Department of Surgical OncologyL’Archet II University HospitalNiceFrance
  9. 9.Department of Surgical OncologyCharles Nicolles University HospitalRouenFrance
  10. 10.Department of Digestive SurgeryCentre Hospitalier Lyon SudPierre-BéniteFrance
  11. 11.Department of Surgical OncologyPaoli Calmettes InstituteMarseilleFrance
  12. 12.RENAPE, Hospices Civils de LyonCentre Hospitalier Lyon SudPierre-BéniteFrance
  13. 13.Unité de Recherche Clinique, Pôle de Santé PubliqueHospices Civils de LyonPierre-BéniteFrance
  14. 14.EMR 3738Lyon 1 UniversityLyonFrance
  15. 15.Department of SurgeryInstitut de Cancérologie de LorraineVandoeuvre-les-NancyFrance
  16. 16.UMR 7039CNRS-Université de Lorraine, CRANVandoeuvre-les-NancyFrance

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