Comprehensive management of diffuse malignant peritoneal mesothelioma

P. H. Sugarbaker*, T. D. Yan, O. A. Stuart, D. Yoo

*Corresponding author for this work

Research output: Contribution to journalArticle

106 Citations (Scopus)

Abstract

Aims: In the past, diffuse malignant peritoneal mesothelioma (DMPM) has been regarded as a terminal condition. The length of the survival was dependent upon the aggressive versus indolent biology of the neoplasm, nevertheless cure was not considered as a reasonable expectation and the overall median survival was approximately one year. Methods: A comprehensive literature review and a collection of pertinent data published on DMPM from the Washington Cancer Institute were used to construct this report. Results: Recent publications from Bethesda MD, New York, Milan Italy, Lyon France and Washington DC have shown a remarkable prolongation in the median survival of this group of patients with approximately half the patients alive at 5 years. These prolonged survivors were treated with an intensive local-regional treatment strategy that included cytoreductive surgery (CRS) with peritonectomy and hyperthermic intraoperative intraperitoneal chemotherapy (HIIC) and some patients with early postoperative intraperitoneal chemotherapy (EPIC). As larger numbers of patients have been treated, clinical features by which to select patients most likely to benefit from this approach have been identified. Also, as the experience in the management of patients receiving these treatments has increased, the morbidity and mortality associated with their management is being reduced. Conclusions: A new standard of care involves surgical removal of large disease deposits combined with perioperative intraperitoneal chemotherapy. Knowledgeable management uses selection criteria and incurs low morbidity and mortality.

Original languageEnglish
Pages (from-to)686-691
Number of pages6
JournalEuropean Journal of Surgical Oncology
Volume32
Issue number6
DOIs
Publication statusPublished - Aug 2006
Externally publishedYes

Keywords

  • Cytoreductive surgery
  • Intraperitoneal chemotherapy
  • Peritoneal mesothelioma
  • Peritonectomy

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