　　Surgical oncologist Dr . Edward Levine was not surprised by the encouraging results of the recent study measuring quality-of-life issues following aggressive treatment for patients with peritoneal mesothelioma .

　　He has been seeing it regularly for several years .

　　“ It just confirmed my clinical gestalt of how patients

　　did , ” Levine told The Mesothelioma Center at Asbestos . com . “ But it was nice to now quantify it with standardized , accepted quality-of-life measures . ”

　　The potential benefits outweighed the risks .

　　Levine , chief of the surgical oncology program at Wake Forest Baptist Comprehensive Cancer Center , is a nationally recognized specialist in peritoneal surface malignancies .

　　He is the senior author of the study that questioned 46 mesothelioma patients who underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy , also known as HIPEC .

　　Annals of Surgical Oncology published the study in May 2019 .

　　Patients completed surveys preoperatively to establish a baseline , then again at three , six , 12 and 24 months after completion of the surgery and HIPEC combination .

　　“ Patients who go through the treatment tend to have good quality of life after recovering from the acute effects of surgery , ” Levine said . “ If we can get patients to these procedures , many of them will be long-term survivors . ”

　　Procedure Produces Long-Term Survivors

　　Much of the work was presented at the Society of Surgical Oncology meeting in Chicago last spring .

　　Median survival was 3 . 4 years . One- , three-and five-year survival rates were 77.4 % , 55.2 % and 36.5 % , respectively .

　　An earlier study at Wake Forest reported a five-year survival rate of 45 % , but it included only patients who achieved a complete cytoreduction .

　　Several patients in this latest study had incomplete cytoreduction with only palliative intent .

　　The quality-of-life measurements—mental and physical—were considerably higher for those with the complete resection .

　　Researchers used multiple verified quality-of-life surveys . The median age of the patients was 52.8 years at time of treatment , and 52%were male .

　　Mental and Physical Quality of Life

　　Patients were questioned on topics such as :

　　• Physical functioning

　　• Bodily pain

　　• General Health

　　• Vitality

　　• Social functioning

　　• Mental health

　　• Depression

　　Researchers concluded that after treatment , quality of life typically went down before it went up .

　　When compared to pretreatment measurements , physical function decreased at three months , reached baseline by six months and steadily improved until 24 months .

　　The emotional well-being scores also were decreased at three months , but significantly increased through the next 21 months .

　　Authors wrote that the initial decrease in quality of life after surgery likely was because of pain and limitations associated with the large incision and physiologic impact of complications .

　　They also noted 30% of patients had no significant complications after surgery .

　　A decrease in quality-of-life measures after 24 months was attributed to disease recurrence .

　　Procedure Has Become Standard of Care

　　The combination of cytoreduction and HIPEC can be a debilitating procedure , lasting from 8-12 hours .

　　The surgeon first removes all visible tumor growth , which often has metastasized throughout the abdominal cavity .

　　A heated chemotherapy solution is then circulated for up to 90 minutes before it is removed .

　　The high-dose chemotherapy solution is designed to reach the microscopic tumor cells that evaded the surgeon .

　　The Peritoneal Surface Oncology Group International began listing the treatment combination as standard of care for peritoneal mesothelioma more than a decade ago .

　　“ This is probably the procedure of choice for patients who are candidates for it , ” Levine said . “ But it is a major operative undertaking with significant risks . ”

　　Procedure Not for Every Patient

　　With many patients , the disease is too advanced when first diagnosed that it prevents them from being candidates for this aggressive treatment combination .

　　For those who qualify , though , aggressive treatment most often proves to be worth the risk .

　　“ This study shows that the improvement in quality of life can be very significant compared with the preoperative status , ” Levine said . “ By six months , virtually all of the patients had recovered to preoperative baseline or better quality-of-life measures . ”

　　新闻来源网址： https : // www . asbestos . com / news / 2019 / 05 / 22 / peritoneal-hipec-quality-life /

Study Results Show Low Morbidity,Mortality Rates for Patients Treated with HIPEC 　　TUESDAY,JUNE 11,2013 　　BUFFALO,NY—Researchers at Roswell Park Comprehensive Cancer Center(Roswell Park)have determined that cytoreductive surgery combined with hyperther

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