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Abstract

Background

Malignant mesothelioma is a rare, insidious, and aggressive tumor arising from the mesothelial surface of pleural and peritoneal cavities, the pericardium, or the tunica vaginalis, with an increasing incidence worldwide, high misdiagnosis rate, and overall negative prognosis. A total of 20 % of all cases is peritoneum in origin.

Methods

The present study is a review of literatures focusing on the advances in epidemiology, clinical presentations, radiological features, diagnosis, misdiagnosis, management, and prognostic factors of malignant peritoneal mesothelioma (MPM) occurred in the past decades.

Results

Asbestos, SV40, and radiation exposures have been demonstrated to be correlated with the pathogenesis of MPM. The main presentations are abdominal distension and pain. Computed tomography (CT), magnetic resonance imaging (MRI), and positron-emission tomography (PET) play an important role in the preoperative imaging and staging. Definitive diagnosis is made on the basis of immunohistochemistry. Prognostic factors have been identified and verified. Negative indicators include advanced age, male gender, poor performance status, non-epithelial histology, and absence of surgery. The management of MPM has evolved from single chemotherapy to multimodality treatment of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), chemotherapy, radiotherapy, and immunotherapy. Promising results have been achieved after a combined treatment of CRS and HIPEC, with an elevated median survival time of 29.5–92 months and a 5-year survival rate of 39–63 %.

Conclusions

CRS and HIPEC represent the standard treatment strategy for selected patients with MPM, and patients with unresectable tumors can benefit from the combined treatment of chemotherapy, radiotherapy, and immunotherapy.

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Acknowledgments

This work was supported by Wujieping Foundation (No. 320.6750.12204), Young People Research Fund for the grant National Natural Scientific Foundation of China (No. 81201828), Young People Foundation of Heilongjiang Provincial of China (No. QC2012C013), National Natural Scientific Foundation of China (No. 81101758), Health Department of Heilongjiang Provincial of China (No: 2011-124) and Harbin Medical University Cancer Hospital major project Foundation (No: JJZ-2010-01).

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Correspondence to Yan Yu.

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Shoubo Cao and Shi Jin contributed equally to this work and should be considered co-first authors.

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Cao, S., Jin, S., Cao, J. et al. Advances in malignant peritoneal mesothelioma. Int J Colorectal Dis 30, 1–10 (2015). https://doi.org/10.1007/s00384-014-2029-1

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