Concerning CT Features Predict Outcome of Treatment in Patients with Malignant Peritoneal Mesothelioma

Background: Malignant peritoneal mesothelioma is an aggressive local-regional disease with dissemination to all parts of the abdomen and pelvis at the time of diagnosis. Recently, cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has been used and improved survival was documented with this local-regional treatment strategy.

Method: Concerning CT features were described that were specific for malignant peritoneal mesothelioma. The incidence of concerning radiologic features and their impact on survival was determined. The prognostic assessment of concerning CT features was compared to the peritoneal cancer index (PCI) and the completeness of cytoreduction score (CC score).

Results: One hundred patients with a preoperative CT were evaluated by 11 concerning CT features. The incidence of these CT features varied between 5% and 41%. Nine of the 11 CT features statistically significantly predicted a reduced survival in these patients treated in a uniform manner. When concerning radiologic features were grouped as none, a single feature or two or more features, a significant composite analysis was achieved with p < 0.001. The prognostic information from concerning CT features compared favorably with the prognostic implications of PCI and CC score.

Conclusions: The availability of the concerning CT features to predict prognosis at the initiation of treatments for malignant peritoneal mesothelioma shows that this radiologic assessment may be of great value to the clinician in planning a treatment strategy for an individual patient.