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Annals of Oncology Advance Access published online on July 27, 2009
Annals of Oncology, doi:10.1093/annonc/mdp307
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© The Author 2009. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

Malignant peritoneal mesothelioma: a multicenter study on 81 cases

V. de Pangher Manzini1,*, L. Recchia1, M. Cafferata2, C. Porta3, S. Siena4, L. Giannetta4, F. Morelli5, F. Oniga6, A. Bearz7, V. Torri8 and M. Cinquini8

1 Division of Medical Oncology, Department of Internal Medicine and Oncology, Monfalcone Hospital, Monfalcone
2 Division of Medical Oncology, Department of Internal Medicine and Oncology, Casale Monferrato Hospital, Casale Monferrato
3 Department of Medical Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, San Matteo University Hospital Foundation, Pavia
4 The Falck Division of Medical Oncology, Niguarda Ca’ Granda Hospital, Milan
5 Department of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, Casa Sollievo della Sofferenza, San Giovanni Rotondo
6 Division of Medical Oncology, Department of Oncology, Venice-Mestre Hospital
7 Department of Medical Oncology, Centro di Riferimento Oncologico - Istituto di Ricovero e Cura a Carattere Scientifico, Aviano
8 Department of Oncology, Mario Negri Institute, Milan, Italy

* Correspondence to: Dr V. de Pangher Manzini, Medical Oncology, Department of Internal Medicine and Oncology, Monfalcone Hospital, Monfalcone, via Galvani 1, 34074 Monfalcone (Gorizia), Italy. Tel: +39-0481487221; Fax: +39-0481592296; E-mail: vincenzo.depangher{at}ass2.sanita.fvg.it

Background: Malignant peritoneal mesothelioma (MPM) is a rare disease characterized by a difficult diagnosis, different types of presentation, variable course and poor prognosis.

Materials and methods: Eighty-one patients with MPM observed in 14 Italian oncology institutions from 1982 to 2007 have been examined with the aim of delineating the history of MPM.

Results: Presentation symptoms were ascites, abdominal pain, asthenia, weight loss, anorexia, abdominal mass, fever, diarrhea and vomiting in various associations. Computed tomography scan and echotomography signs were ascites, abdominal mass and peritoneal thickening. Peritoneal fluid cytology (61 cases) was positive for mesothelioma in 31 and for malignancy, not mesothelioma, in 13. Laparoscopy was carried out in 40 cases and laparotomy in 36. Thrombocytosis was present in 59 cases. Associated tumors diagnosed during the lifetime were colorectal cancer in two cases and cheek carcinoma, thyroid carcinoma, tongue carcinoma, bladder carcinoma and testicular seminoma. Thirty patients were treated with surgery and 45 with chemotherapy. The median survival time from diagnosis is 13 months. Ascites, fever and vomiting were significative variables at presentation; only vomiting holds significance in a multivariate analysis.

Conclusions: MPM is a disease with various types of presentation, frequently associated with thrombocytosis, sometimes with other tumors. Survival and diagnosis time can differ in various types of MPM. Prognosis is poor.

asbestos, diagnosis, mesothelioma, peritoneum, prognosis, thrombocytosis

Received for publication September 3, 2008. Revision received February 23, 2009. Accepted for publication May 6, 2009.


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