Diffuse malignant mesothelioma of the peritoneum

Abstract

Peritoneal mesothelioma is a rare disease. In the past the prognosis was dismal. Asbestos is incriminated for the development of the disease with various pathophysiologic mechanisms. Maximal cytoreductive surgery combined with intraperitoneal chemo-therapy has offered significant survival benefit to patients with peritoneal mesothelioma. Cytoreductive surgery is possible with standard peritonectomy procedures and intends to removal of the macroscopically visible tumor. Intraperitoneal chemotherapy either as intraoperative hyperthermic or as early postoperative under normothermia intends to eradicate the residual microscopic tumor. The rate of hospital mortality is low but morbidity is high. The extent of peritoneal carcinomatosis and the completeness of cytoreduction are the most significant prognostic indicators of survival.