The Role of CRS and HIPEC in the Management of Diffuse Malignant Peritoneal Mesothelioma (DMPM)

Peritoneal mesothelioma is a rare disease with an incidence of approx. 0.2–3 per million in industrialized countries and originates from mesothelial cells of the peritoneum. The treatment of this malignant disease depends on the patient condition and aggressiveness of the tumor, which corresponds to three different histopathologic subtypes: epithelioid, sarcomatoid, and biphasic. The prognosis of the epithelioid subtype of peritoneal mesothelioma is considerably better compared with sarcomatoid or biphasic, which have a poor prognosis. Cytoreductive surgery in combination with hyperthermic intraperitoneal chemotherapy has been established as an effective treatment option for selected patients, resulting in a median overall survival of more than 50 months compared with 1 or 2 years in patients treated with palliative chemotherapy. This chapter explores the epidemiologic background and highlights the diagnostic aspects and treatment options for patients with peritoneal mesothelioma.