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International Journal of Colorectal Disease
Published in: International Journal of Colorectal Disease 1/2015

01-01-2015 | Review

Advances in malignant peritoneal mesothelioma

Authors: Shoubo Cao, Shi Jin, Jingyan Cao, Jing Shen, Jing Hu, Dehai Che, Bo Pan, Jiawen Zhang, Xiaoxi He, Dian Ding, Feifei Gu, Yan Yu

Published in: International Journal of Colorectal Disease | Issue 1/2015

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Abstract

Background

Malignant mesothelioma is a rare, insidious, and aggressive tumor arising from the mesothelial surface of pleural and peritoneal cavities, the pericardium, or the tunica vaginalis, with an increasing incidence worldwide, high misdiagnosis rate, and overall negative prognosis. A total of 20 % of all cases is peritoneum in origin.

Methods

The present study is a review of literatures focusing on the advances in epidemiology, clinical presentations, radiological features, diagnosis, misdiagnosis, management, and prognostic factors of malignant peritoneal mesothelioma (MPM) occurred in the past decades.

Results

Asbestos, SV40, and radiation exposures have been demonstrated to be correlated with the pathogenesis of MPM. The main presentations are abdominal distension and pain. Computed tomography (CT), magnetic resonance imaging (MRI), and positron-emission tomography (PET) play an important role in the preoperative imaging and staging. Definitive diagnosis is made on the basis of immunohistochemistry. Prognostic factors have been identified and verified. Negative indicators include advanced age, male gender, poor performance status, non-epithelial histology, and absence of surgery. The management of MPM has evolved from single chemotherapy to multimodality treatment of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), chemotherapy, radiotherapy, and immunotherapy. Promising results have been achieved after a combined treatment of CRS and HIPEC, with an elevated median survival time of 29.5–92 months and a 5-year survival rate of 39–63 %.

Conclusions

CRS and HIPEC represent the standard treatment strategy for selected patients with MPM, and patients with unresectable tumors can benefit from the combined treatment of chemotherapy, radiotherapy, and immunotherapy.
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Metadata
Title
Advances in malignant peritoneal mesothelioma
Authors
Shoubo Cao
Shi Jin
Jingyan Cao
Jing Shen
Jing Hu
Dehai Che
Bo Pan
Jiawen Zhang
Xiaoxi He
Dian Ding
Feifei Gu
Yan Yu
Publication date
01-01-2015
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Colorectal Disease / Issue 1/2015
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-014-2029-1

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