Peritoneal mesothelioma

Abstract

Malignant peritoneal mesothelioma is an aggressive neoplasm that rapidly spreads within the confines of the abdominal cavity to involve most accessible peritoneal and omental surfaces. Current treatments are unsatisfactory, and new approaches are needed. We have noted prolonged survival in selected patients after intensive multimodality treatment. Our current experimental regimen includes initial laparotomy with omentectomy, resection of peritoneal implants, and placement of bilateral peritoneal Port-a-Caths (Sims Deltec, Inc., St. Paul, MN); repeated courses of intraperitoneal chemotherapy with doxorubicin, cisplatin, and interferon gamma; second-look laparotomy and intraoperative hyperthermic perfusion with mitomycin and cisplatin; and whole abdominal radiation. Patients with peritoneal mesothelioma who are not candidates for this approach can sometimes be palliated with systemic (intravenous) chemotherapy using doxorubicin or mitomycin, alone or in combination with cisplatin or carboplatin. Newer agents such as gemcitabine and multitargeted antifolate (pemetrexed disodium, LY231514) show promise of greater effectiveness.

Molecular profiling of malignant peritoneal mesothelioma identifies the ubiquitin–proteasome pathway as a therapeutic target in poor prognosis tumors

“…The annual incidence in the United States is approximately 2500 cases per year of which approximately 25% are peritoneal mesothelioma (Taub et al, 2000). Peritoneal mesothelioma is associated with documented asbestos exposure, but less frequently than pleural mesothelioma (15-30 vs 60-70%).…”

Omental mesothelioma as a diagnostic and therapeutic challenge: A case report

“…Cytological analysis of the fluid may help, however, diagnosis is usually established by laparotomy or laparoscopy. At the time of diagnosis, the mean age is 60 years, and the female male ratio is 1:3 [7]. Most of the patients have a history of asbestos exposure [1,4].…”

“…Larger nodules (2-5 cm) and infiltrative masses are commonly observed. At advanced stages, tumors mostly infiltrate the omentum and pleural cavity via the trans diaphragmatic route and exhibit distant metastasis [6,7]. To the best of our knowledge, only three cases of malignant mesothelioma originating from the omentum have been reported [2][3][4].…”

“…After the diagnosis, the mean survival is 9-18 months for peritoneal tumors and 4-12 months for pleural tumors in cases of untreated patients [7]. Systemic chemotherapy and radiotherapy have little effect on the course of the disease, and complete surgical resection is not that beneficial [1].…”

Physicochemical and pharmacokinetic properties of polymeric films loaded with cisplatin for the treatment of malignant pleural mesothelioma

“…Furthermore, the life expectancy for mesothelioma-stricken patients is 4-12 months after the diagnosis, if a therapy is not initiated in the early stages of the disease. Current mesothelioma treatment is unsatisfactory and local tumor recurrence is common, even after complete surgical resection combined with chemotherapy and radiotherapy (3,4).…”