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The following is a summary of “Effect of postoperative normothermic intraperitoneal chemotherapy on the prognosis of MPM patients receiving CRS+HIPEC: a single-center case-control study,” published in the September 2024 issue of Surgery by Liang et al.

The integration of cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC), complemented by systemic and intraperitoneal chemotherapy, is established as the standard treatment for malignant peritoneal mesothelioma (MPM) and has been shown to extend patient survival significantly. This study aims to assess the clinical impact of postoperative normothermic intraperitoneal chemotherapy (NIPEC) on outcomes in patients with MPM. Researchers conducted a retrospective analysis of 152 patients with MPM who underwent CRS+HIPEC followed by postoperative intravenous chemotherapy. Patients were categorized into two groups based on their receipt of NIPEC after surgery: the Non-NIPEC group and the NIPEC group. 

Baseline characteristics and survival outcomes were compared between the groups, with further subgroup analysis conducted based on the completeness of the cytoreduction (CC) score. Multivariate survival analysis was employed to identify independent prognostic factors. The baseline characteristics of the Non-NIPEC and NIPEC groups were comparable in both CC 0-1 and CC 2-3 subgroups. Survival analysis revealed that among patients with CC 0-1, there was no significant difference in overall survival (OS) between the two groups (P=0.503). In contrast, for patients with CC 2-3, those receiving NIPEC had a significantly longer median OS compared to the Non-NIPEC group (24.5 months vs. 10.3 months, P=0.005). 

Pathological type, preoperative thrombosis, and postoperative NIPEC (HR=0.423, 95% CI: 0.228-0.786, P=0.006) were identified as independent prognostic factors for patients with CC 2-3. These findings suggest that postoperative NIPEC can enhance survival in patients with MPM who had a CC score of 2-3, though it does not confer similar benefits to those with a CC score of 0-1.

Source: sciencedirect.com/science/article/abs/pii/S0748798324007443