Salo Silja A S, Ilonen Ilkka, Laaksonen Sanna, Myllärniemi Marjukka, Salo Jarmo A, Rantanen Tuomo
Department of Surgery, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
Anticancer Res. 2019 Feb;39(2):839-845. doi: 10.21873/anticanres.13183.
Malignant peritoneal mesothelioma (MPeM) is a rare type of cancer with a poor prognosis. Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) have been shown to improve survival. Treatment and survival of patients with MPeM have not been previously studied in Finland.
The data consisted of all patients diagnosed with MPeM during years 2000-2012 in Finland, including cancer notifications, death certificates and information about asbestos exposure.
Among 50/94 (53.2%) patients treated for MPeM, 44/50 (88.0%) were treated palliatively, 4/50 (8.0%) with radical surgery and chemotherapy, and 2/50 (4.0%) with CRS plus HIPEC. Five-year survival was 50.0% for those treated with CRS plus HIPEC and 75.0% for those treated with radical surgery and chemotherapy. Radical surgery with chemotherapy was associated with significantly longer survival compared to radiation (p=0.008), chemotherapy and radiation (p=0.043), surgery, chemotherapy and radiation (p=0.039), and palliative surgery (p=0.009).
Treatment of MPeM is heterogenic in Finland. CRS plus HIPEC, and radical surgery with chemotherapy seem to increase the survival. Patients considered candidates for radical surgery should be sent to specialized centers for further assessment.
恶性腹膜间皮瘤（MPeM）是一种罕见的癌症，预后较差。细胞减灭术（CRS）联合腹腔内热灌注化疗（HIPEC）已被证明可提高生存率。此前芬兰尚未对MPeM患者的治疗和生存情况进行过研究。
数据包括2000年至2012年期间在芬兰诊断为MPeM的所有患者，包括癌症通报、死亡证明以及石棉暴露信息。
在50/94（53.2%）例接受MPeM治疗的患者中，44/50（88.0%）例接受姑息治疗，4/50（8.0%）例接受根治性手术和化疗，2/50（4.0%）例接受CRS联合HIPEC。接受CRS联合HIPEC治疗的患者5年生存率为50.0%，接受根治性手术和化疗的患者为75.0%。与放疗（p=0.008）、化疗和放疗（p=0.043）、手术、化疗和放疗（p=0.039）以及姑息性手术（p=0.009）相比，根治性手术联合化疗的患者生存期明显更长。
在芬兰，MPeM的治疗方法各异。CRS联合HIPEC以及根治性手术联合化疗似乎可提高生存率。被认为适合根治性手术的患者应被送往专业中心进行进一步评估。
