Evaluation of malignant peritoneal mesothelioma

Abstract

Purpose: We analyzed the clinical pathology of malignant peritoneum mesothelioma, associated with the asbestos exposure and methods for treatment. Patients and methods: The study group of asbestos-related disease that is presently being performed by the Labor Health and Welfare Organization up to 2007-2013, mesothelioma, of which the national Rosai Hospital is part consists of 264 cases. We investigated 25 cases of peritoneal mesothelioma among them. Results: There were more men (22, 88%), than women (3, 12%). Of these, 23 cases were detected from symptoms, 13 cases of which were feelings of abdominal distension, and 8 cases were abdominal pain. Definitive diagnosis was obtained in 19 cases by histological diagnosis of specimens obtained by surgery or needle biopsy. Six cases were diagnosed by examination of ascites cells. Histologically, 19 cases had epithelial, 3 cases biphasic, and 3 cases sarcomatous mesothelioma. Asbestos exposure history was recognized in 23 cases (92%), of which 14 cases (61%) were high concentration asbestos exposures. We recognized various asbestos-related conditions, pleural plaques in 15 cases, pleural effusion in 6 cases and asbestosis 4 cases. Chemotherapy was performed in 22, surgery plus chemotherapy in 2 cases (radical surgery in one case), best supportive care was carried out in one case. The median survival of all cases was 6.0 months. In a multivariable analysis by the Cox proportional hazards model, age, presence or absence of abdominal pain, and histological type were prognostic factors. Conclusion: This disease, which has been suggested to be associated with asbestos exposure, has been treated mainly by the only option available, systemic chemotherapy alone. Its poor prognosis has been recognized.