Review
Copyright ©2009 Baishideng. All rights reserved.
World J Gastrointest Surg. Nov 30, 2009; 1(1): 38-48
Published online Nov 30, 2009. doi: 10.4240/wjgs.v1.i1.38
Malignant peritoneal mesothelioma
Stine Munkholm-Larsen, Christopher Q Cao, Tristan D Yan
Stine Munkholm-Larsen, Christopher Q Cao, Tristan D Yan, University of Sydney, Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital, Sydney 2050, Australia
Stine Munkholm-Larsen, Christopher Q Cao, Tristan D Yan, Baird Institute for Applied Heart and Lung Surgical, Sydney 2050, Australia
Author contributions: Munkholm-Larsen S, Cao CQ and Yan TD designed and wrote the manuscript.
Correspondence to: Tristan D Yan, BSc (Med), MBBS, PhD, University of Sydney, Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital, Sydney 2050, Australia. tristan.yan@unsw.edu.au
Telephone: +61-2-95155587 Fax: +61-2-95155587
Received: July 2, 2009
Revised: July 27, 2009
Accepted: August 4, 2009
Published online: November 30, 2009
Abstract

Malignant mesothelioma is a highly aggressive neoplasm. The incidence of malignant mesothelioma is increasing worldwide. Diffuse malignant peritoneal mesothelioma (DMPM) represents one-fourth of all mesotheliomas. Association of asbestos exposure with DMPM has been observed, especially in males. The great majority of patients present with abdominal pain and distension, caused by accumulation of tumors and ascitic fluid. In the past, DMPM was considered a pre-terminal condition; therefore attracted little attention. Patients invariably died from their disease within a year. Recently, several prospective trials have demonstrated a median survival of 40 to 90 mo and 5-year survival of 30% to 60% after combined treatment using cytoreductive surgery and perioperative intraperitoneal chemotherapy. This remarkable improvement in survival has prompted new search into the medical science related to DMPM, a disease previously ignored as uninteresting. This review article focuses on the key advances in the epidemiology, diagnosis, staging, treatments and prognosis of DMPM that have occurred in the past decade.

Keywords: Asbestos, Cisplatin, Cytoreductive surgery, Doxorubicin, Intraperitoneal chemotherapy, Mesothelin, Pemetrexed, Peritoneal mesothelioma, Peritonectomy