Clinical picture, response to therapy, and survival of women with diffuse malignant peritoneal mesothelioma

Background and Objectives: The clinical picture, response to therapy, and p rognosis of women with diffuse malignant peritoneal mesotheliomas (DMPM) ar e ill defined. The purpose of this study is to report on the clinical pictu re, response to therapy, and survival of women with DMPM. Methods: The study is a retrospective review of 15 women with the confirmed pathologic diagnosis of DMPM treated between 1964 and 1996. Survival curve s were constructed according to the Kaplan-Meier method. The effect of diff erent factors on survival was studied using the log-rank test. Two-tailed P values < 0.05 were considered significant. Results: Clinical features included abdominal distension (11/15, 73%), abdo minal pain (6/15, 40%), ascites (9/15, 60%), abdominal or pelvic masses (14 /15, 93%), elevated CA-125 (4/4, 100%), thrombocytosis (4/15, 27%), and thr ombo-embolic manifestations (3/15, 20%). The response rate to all first-lin e chemotherapy regimens was 30%. The response rate to paclitaxel/cisplatin was 66.7% and the toxicity was tolerable. The median survival of all patien ts was 12.5 months. Patients who underwent cytoreductive surgery survived l onger than those who underwent biopsy only (median survival 13.5 vs. 6.0 mo nths, P = 0.24). Patients who received chemotherapy survived significantly longer than those who did not receive chemotherapy (29.0 vs. 1.0 months, P = 0.03). Patients who responded to first-line chemotherapy survived signifi cantly longer than those who did not respond (P = 0.04). Conclusions: Cytoreductive surgery and chemotherapy, especially with paclit axel and cisplatin, might be of benefit in women with DMPM. J. Surg. Oncol. 1999;70:6-12. (C) 1999 Wiley-Liss, Inc.