Sashreek Ganguli, Amity University Kolkata
Mesothelioma is a tumour caused by intake of asbestos fibers and forms within the peritoneum of lungs. The occurrence rate is high in people belonging to the age bracket of 80-84 years. To treat this, pemetrexed-based regimen with cytoreductive surgery (CRS) could be a commonly used, but long-term survival is rare with lifespan up to 12-21months, after diagnosis.
Apart from the adults, the paediatric population is simultaneously affected by the condition. Here it’s imperative to say that little was known about the characteristics of mesothelial tumors within the pediatric population. Hence, to further the knowledge on the condition in adolescents, scientists at the European Cooperative Study Group on Pediatric Rare Tumors (EXPeRT) reviewed past paediatric cases(1987-2018). They identified 33 patients and discovered the first tumour mainly within the peritoneum (23 patients).
The histology was multicystic mesothelioma in the peritoneum (MCM) (6 cases) or malignant mesothelioma (MM) (27 cases). There was documented evidence of exposure to asbestos in one case. Within, MM the response to permetrexed was 50% (i.e. 6/12) and survival rate to CRS-Hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) after a follow-up of 6.7 years (range, 0–20), five-year overall and event-free survivals were 82.3% (95% CI, confidential interval ((CI), 67.8–99.9) and 45.1% (95% CI, 28.4–71.7), respectively. In MCM, all patients survived after surgery and CRS-HIPEC. Conclusively, paediatric mesothelioma is different from its adult form with lesser asbestos exposures, more primary tumours in the peritoneum. The cisplatin–pemetrexed regimen showed good efficacy.
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Source: https://doi.org/10.1016/j.ejca.2020.09.011
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