Peritoneal Mesothelioma Treatments

In recent years, multimodality treatment of peritoneal mesothelioma has become more common for a select patient population, since surgery alone and/or intraperitoneal chemotherapy alone have proven to be similarly ineffective. Cytoreductive (debulking) surgery involves the removal of all or nearly all visible tumor, and, depending on the physician’s choice, may be combined with Intra-Peritoneal Hyperthermic Chemotherapy (IPHC), intraperitoneal chemotherapy and/or radiation. Since it is not always possible to remove all tumors, the prognosis for long-term survival may be based on the completeness of cytoreduction as established by the following criteria: (1) Complete Cytoreduction; and (2) Imcomplete cytoreduction.

Due to a lack of symptoms early in the natural history of peritoneal mesothelioma, a large majority of patients are first diagnosed with a large volume of disease diffusely spread throughout the abdomen and pelvis. The disease accumulates in largest volume at sites of peritoneal fluid reabsorption and at dependent sites by gravity. The small bowel surfaces and mesenteries are not spared of mesothelioma implants as in the mucinous appendiceal neoplasms.