ASO Author Reflections: Hormonal Status May Impact Outcomes in Peritoneal Mesothelioma After CRS/HIPEC

Our plain-English summary of ASO Author Reflections: Hormonal Status May Impact Outcomes in Peritoneal Mesothelioma After CRS/HIPEC, by K.C. Cummins, S.M. Ruff (Annals of Surgical Oncology, 2026).

The study

• Authors: K.C. Cummins, S.M. Ruff
• Journal: Annals of Surgical Oncology
• Published: 2026;33(6):5319-5320
• Read it: PubMed · Publisher · Free full text

In plain English

This two-page article is an "Author Reflections" commentary in which two of the authors described their own study, which was published separately in the same journal. That study used the National Cancer Database to examine 1868 adult patients with epithelioid peritoneal mesothelioma who underwent CRS/HIPEC (cytoreductive surgery combined with heated chemotherapy delivered into the abdomen). The authors reported that CRS/HIPEC appeared underused even among patients with favorable clinical profiles. They also reported that male sex was independently associated both with receiving CRS/HIPEC and with worse overall survival. The commentary does not say in which direction the treatment association ran. To explore hormones, the authors grouped patients by sex and age, using age 40 or younger and age 60 or older as stand-ins for before and after menopause. Premenopausal women had significantly better overall survival than postmenopausal women and than men in either age group. No survival figures were given. Asbestos was not discussed. The authors concluded that this suggests a potential prognostic role for sex hormones and called for prospective studies with direct hormone measurements.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Author commentary ("ASO Author Reflections") summarizing the authors' own retrospective analysis of the National Cancer Database, published separately
• Who was studied: 1868 adult patients with epithelioid peritoneal mesothelioma who underwent CRS/HIPEC, from the National Cancer Database. Years and location are not stated in this commentary.
• Exposure: Not asbestos. The factors studied were sex and age, combined into a sex-age variable, with age 40 or younger and age 60 or older used as proxies for premenopausal and postmenopausal status. Treatment with CRS/HIPEC was also examined.
• Main results:
  • CRS/HIPEC appeared underutilized, even among patients with favorable clinical profiles.
  • Male sex was independently associated both with receiving CRS/HIPEC and with worse overall survival. The direction of the association with receiving treatment is not stated, and no figures are given.
  • Premenopausal women (age proxy 40 or younger) had significantly improved overall survival compared with postmenopausal women, younger men and older men. No survival figures are given.
• The authors' conclusion: The authors concluded that the findings suggest a potential prognostic role for sex hormones in these patients. They wrote that further investigation, including prospective studies with direct hormone measurements and hormone receptor characterization, is needed, along with study of practice patterns behind sex-based differences in CRS/HIPEC use.

Topics

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, HIPEC.

Related studies

• ASO Author Reflections: Long-Term Survival Is Feasible After Complete CRS/HIPEC for Biphasic Peritoneal Mesothelioma — K. Chouliaras, K.I. Votanopoulos (2018)
• ASO Author Reflections: Analysis of Treatment Strategies and Outcomes in Malignant Peritoneal Mesothelioma: Insights from a Multi-center Study — S. Yaşar (2024)
• ASO Author Reflections: Improving Outcomes in Diffuse Malignant Peritoneal Mesothelioma: Challenges and Opportunities — J.C. Leinwand, M.D. Kluger (2020)
• ASO Author Reflections: Expert Surgical Evaluation is Critical for Patients with Diffuse Malignant Peritoneal Mesothelioma: Lessons Learned from Assessing Outcomes of 2000 Patients — L. Bijelic, T. Cannon (2020)
• Hormonal Status May Contribute to Sex-Based Survival Differences in Epithelioid Peritoneal Mesothelioma — K.C. Cummins, O. Sears, et al. (2026)
• ASO Author Reflections: Management of Malignant Peritoneal Mesothelioma — T.R. Cushman, V. Verma, et al. (2018)

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