Diagnostic and therapeutic analyses for peritoneal malignant mesothelioma: a report of 26 women

Abstract

To investigate the etiology, clinicopathologic features and prognosis of peritoneal malignant mesothelioma (PMM). The diagnostic and therapeutic data for PMM from March 2000 to December 2010 were retrospectively analyzed for 26 women. They had an age range of 41 - 78 years old. Among them, 21 patients (81%) had a history of exposure to asbestos. Their major symptoms were abdominal distension, abdominal pain, ascites and abdominopelvic mass. Some had cachexia. Intestinal obstruction occurred in all cases during a late stage. Among them, the tumor marker of CA125 increased markedly in serum and ascitic samples. The positive rate of ascitic cytology was 31%. Type B ultrasound and CT (computed tomography) examinations showed ascites, peritoneal thickening and abdominopelvic mass and pie-shaped omentum. Their general pathological classifications were as follows: diffuse type (n = 23), localized type (n = 3), epithelial (n = 14), sarcoma (n = 3) and mixed type (n = 9). Cytoreductive surgery was performed in 16 cases. Ten patients underwent only laparoscopy while 23 patients received chemotherapy. The comparison of life span was not statistically significant between cytoreductive surgery and laparoscopy (P > 0.05); the difference of life span between ≤ 6 courses of chemotherapy and < 6 courses was not statistically significant (P > 0.05). The history of exposure to asbestos is a risk factor for PMM. PMM with no specific clinical features should be combined with laboratory and imaging studies to make a timely clinical diagnosis. Final diagnosis should be based upon histopathological and immunohistochemical examinations. Surgery and chemotherapy do not prolong the life span of patients. And the patients have a very poor prognosis.