Diffuse malignant peritoneal mesothelioma (DMPM) is a rare cancer that is ultimately fatal in all afflicted individuals. DMPM represents only 15% to 20% of all mesothelioma diagnoses, with most being the pleural variant. Approximately 400 new cases of DMPM are diagnosed annually in the United States, with men and women having an equal incidence of the disease.1,2 Several risk factors have been implicated in the development of DMPM. Data indicating a strong association between asbestos exposure and the development of disease have been available for decades.3 Although the risk of peritoneal mesothelioma attributed to asbestos exposure may differ between the sexes, these differences may be from misclassification of exposure in women.4 Other factors found to be associated with peritoneal mesothelioma development are previous abdominal radiation and the mineral erionite.5,6 Less substantiated and more controversial putative risk factors include a diet low in vegetable consumption, and simian virus 40 infection from contaminated polio vaccines.7,8
The first convincing description of DMPM as a distinct clinical entity representing a diffuse primary malignant process of the peritoneal serosa was provided more than 100 years ago. In 1908, Miller and Wynn9 published what is widely believed to be the first documented case of DMPM. In their report, a 32-year-old male miller who presented with abdominal pain and ascites was noted to have an extensive and diffuse intraperitoneal neoplastic process that was not amenable to resection at surgical exploration. He was treated palliatively and succumbed to disease 1 year later. A review of the literature 50 years later found only 13 pathologically confirmed cases of DMPM.10 However, after that detailed description of the tumor's pathologic features, a marked increase occurred in the number of documented cases in the medical literature, accompanied by an initial understanding of the risk factors and clinical features of the condition. From 1960 until the publication of Moertel's widely acclaimed review of the subject in 1972, at least 169 cases were documented in the literature.11 Despite the initial description of DMPM in the early 20th century, results of clinical trials and treatment strategies specifically for patients with DMPM were not reported until the end of the century.
Price B, Ware A. Time trend of mesothelioma incidence in the United States and projection of future cases: an update based on SEER data for 1973 through 2005. Crit Rev Toxicol 2009;39:576-588.
Moolgavkar SH, Meza R, Turim J. Pleural and peritoneal mesotheliomas in SEER: age effects and temporal trends, 1973-2005. Cancer Causes Control 2009;20:935-944.
Spirtas R, Heineman EF, Bernstein L. Malignant mesothelioma: attributable risk of asbestos exposure. Occup Environ Med 1994;51:804-811.
Carbone M, Emri S, Dogan AU. A mesothelioma epidemic in Cappadocia: scientific developments and unexpected social outcomes. Nat Rev Cancer 2007;7:147-154.
Miller JA, Wynn WH. Malignant tumor arising from endothelium of peritoneum, and producing mucoid ascitic fluid. J Pathol Bacteriol 1908;12:267-278.
Winslow DJ, Taylor HB. Malignant peritoneal mesotheliomas: a clinicopathological analysis of 12 fatal cases. Cancer 1960;13:127-136.
Alexander HR, Hanna N, Pingpank JF. Clinical results of cytoreduction and HIPEC for malignant peritoneal mesothelioma. Cancer Treat Res 2007;134:343-355.
Sugarbaker PH, Welch LS, Mohamed F, Glehen O. A review of peritoneal mesothelioma at the Washington Cancer Institute. Surg Oncol Clin N Am 2003;12:605-621, xi.
Antman KH, Blum RH, Greenberger JS. Multimodality therapy for malignant mesothelioma based on a study of natural history. Am J Med 1980;68:356-362.
Baratti D, Kusamura S, Martinetti A. Prognostic value of circulating tumor markers in patients with pseudomyxoma peritonei treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy. Ann Surg Oncol 2007;14:2300-2308.
Antman K, Shemin R, Ryan L. Malignant mesothelioma: prognostic variables in a registry of 180 patients, the Dana Farber Cancer Institute and Brigham and Women's Hospital experience over two decades, 1965-1985. J Clin Oncol 1988;6:147-153.
Eltabbakh GH, Piver MS, Hempling RE. Clinical picture, response to therapy, and survival of women with diffuse malignant peritoneal mesothelioma. J Surg Oncol 1999;70:6-12.
Low RN, Sebrechts CP, Barone RM, Muller W. Diffusion-weighted MRI of peritoneal tumors: comparison with conventional MRI and surgical and histopathologic findings—a feasibility study. AJR Am J Roentgenol 2009;193:461-470.
Park JY, Kim KW, Kwon HJ. Peritoneal mesotheliomas: clinicopathologic features, CT findings, and differential diagnosis. AJR Am J Roentgenol 2008;191:814-825.
Yan TD, Haveric N, Carmignani CP. Computed tomographic characterization of malignant peritoneal mesothelioma. Tumori 2005;91:394-400.
Levy AD, Arnaiz J, Shaw JC, Sobin LH. From the archives of the AFIP: primary peritoneal tumors: imaging features with pathologic correlation. Radiographics 2008;28:583-607.
Daya D, McCaughey WT. Well-differentiated papillary mesothelioma of the peritoneum. A clinicopathologic study of 22 cases. Cancer 1990;65:292-296.
Hassan R, Alexander R. Nonpleural mesotheliomas: mesothelioma of the peritoneum, tunica vaginalis, and pericardium. Hematol Oncol Clin North Am 2005;19:1067-1087, vi.
Feldman AL, Libutti SK, Pingpank JF. Analysis of factors associated with outcome in patients with malignant peritoneal mesothelioma undergoing surgical debulking and intraperitoneal chemotherapy. J Clin Oncol 2003;21:4560-4567.
Cerruto CA, Brun EA, Chang D, Sugarbaker PH. Prognostic significance of histomorphologic parameters in diffuse malignant peritoneal mesothelioma. Arch Pathol Lab Med 2006;130:1654-1661.
Husain AN, Colby TV, Ordonez NG. Guidelines for pathologic diagnosis of malignant mesothelioma: a consensus statement from the International Mesothelioma Interest Group. Arch Pathol Lab Med 2009;133:1317-1331.
Garcia-Carbonero R, Paz-Ares L. Systemic chemotherapy in the management of malignant peritoneal mesothelioma. Eur J Surg Oncol 2006;32:676-681.
Vogelzang NJ, Rusthoven JJ, Symanowski. Phase III study of pemetrexed in combination with cisplatin versus cisplatin alone in patients with malignant pleural mesothelioma. J Clin Oncol 2003;21:2636—2644.
Janne PA, Wozniak AJ, Belani CP. Open-label study of pemetrexed alone or in combination with cisplatin for the treatment of patients with peritoneal mesothelioma: outcomes of an expanded access program. Clin Lung Cancer 2005;7:40-46.
Simon GR, Verschraegen CF, Janne PA. Pemetrexed plus gemcitabine as first-line chemotherapy for patients with peritoneal mesothelioma: final report of a phase II trial. J Clin Oncol 2008;26:3567-3572.
Yan TD, Deraco M, Baratti D. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for malignant peritoneal mesothelioma: multi-institutional experience. J Clin Oncol 2009;27:6237-6242.
Deraco M, Nonaka D, Baratti D. Prognostic analysis of clinicopathologic factors in 49 patients with diffuse malignant peritoneal mesothelioma treated with cytoreductive surgery and intraperitoneal hyperthermic perfusion. Ann Surg Oncol 2006;13:229-237.
Sugarbaker PH, Yan TD, Stuart OA, Yoo D. Comprehensive management of diffuse malignant peritoneal mesothelioma. Eur J Surg Oncol 2006;32:686-691.
Mongero LB, Beck JR, Kroslowitz RM. Treatment of primary peritoneal mesothelioma by hyperthemic intraperitoneal chemotherapy. Perfusion 1999;14:141-145.
Chua TC, Yan TD, Morris DL. Outcomes of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal mesothelioma: the Australian experience. J Surg Oncol 2009;99:109-113.
Blackham AU, Shen P, Stewart JH. Cytoreductive surgery with intraperitoneal hyperthermic chemotherapy for malignant peritoneal mesothelioma: mitomycin versus cisplatin. Ann Surg Oncol 2010;17:2720-2727.
Deraco M, Casali P, Inglese MG. Peritoneal mesothelioma treated by induction chemotherapy, cytoreductive surgery, and intraperitoneal hyperthermic perfusion. J Surg Oncol 2003;83:147-153.
Rueth NM, Murray SE, Huddleston SJ. Severe electrolyte disturbances after hyperthermic intraperitoneal chemotherapy: oxaliplatin versus mitomycin C. Ann Surg Oncol 2011;18:174-180.
Brigand C, Monneuse O, Mohamed F. Peritoneal mesothelioma treated by cytoreductive surgery and intraperitoneal hyperthermic chemotherapy: results of a prospective study. Ann Surg Oncol 2006;13:405-412.
Loggie BW, Fleming RA, McQuellon RP. Prospective trial for the treatment of malignant peritoneal mesothelioma. Am Surg 2001;67:999-1003.
Varghese S, Chen Z, Bartlett DL. Activation of the phosphoinositide-3-kinase and mammalian target of rapamycin signaling pathways are associated with shortened survival in patients with malignant peritoneal mesothelioma. Cancer 2011;117:361-371.
Foster JM, Radhakrishna U, Govindarajan V. Clinical implications of novel activating EGFR mutations in malignant peritoneal mesothelioma. World J Surg Oncol 2010;8:88.
Govindan R, Kratzke RA, Herndon JE. Gefitinib in patients with malignant mesothelioma: a phase II study by the Cancer and Leukemia Group B. Clin Cancer Res 2005;11:2300-2304.
Garland LL, Rankin C, Gandara DR. Phase II study of erlotinib in patients with malignant pleural mesothelioma: a Southwest Oncology Group Study. J Clin Oncol 2007;25:2406-2413.
Hesdorffer ME, Chabot JA, Keohan ML. Combined resection, intraperitoneal chemotherapy, and whole abdominal radiation for the treatment of malignant peritoneal mesothelioma. Am J Clin Oncol 2008;31:49-54.