Surgical Treatment of Malignant Peritoneal Mesothelioma: Past, Present, and Future

Excerpt

Malignant peritoneal mesothelioma (MPM) is a rare malignancy that arises from the serosal membranes of the abdominal cavity. In 1972, Moertel published a paper characterizing the clinical course of patients afflicted with MPM and the now recognized clinical features associated with tumor progression within the abdominal cavity.1 Borow first reported the association between asbestos exposure and mesothelioma that same year.2 Despite the current recognition that MPM is a distinct entity from its pleural variant, progress in the treatment of patients afflicted with MPM has been hampered by several factors. First, it is an extraordinarily rare condition: only 10–15% of all patients with mesothelioma present with the peritoneal form of the disease, and this translates into approximately 300–400 cases in the USA annually. As a consequence, throughout the last two decades many clinical trials testing systemic agents for patients with malignant mesothelioma did not distinguish between those with the pleural versus the peritoneal form of disease.3‐5 Many of these trials included a small number of patients with MPM and for whom no confident conclusions regarding efficacy of the experimental regimen could be made. It is now becoming increasingly recognized that patients with MPM have a distinct disease for which specific therapies should be developed. …