title: Peritoneal cystic mesothelioma: are surgery and HIPEC optimal first-line treatments?
abstract: BACKGROUND
  Peritoneal cystic mesothelioma (PCM) is an uncommon clinical pathology. Its high rate of recurrence following partial or total resection as well as its spontaneous onset of malignancy have been well documented in a series of case studies. The medical community has yet to define standardized treatment guidelines for PCM.
  
  
  METHODS
  This study reviews the case of 2 patients admitted and treated for PCM. Recent studies have reported improved recurrence and survival rates achieved by means of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), especially when used as first-line treatments. However, whether or not the use of CRS and HIPEC is more effective than a surgical regimen of multiple debulking procedures, is still the subject of debate.
  
  
  CONCLUSIONS
  CRS and HIPEC as first-line treatments have lower morbidity and mortality rates than regimens of multiple back-to-back surgical procedures, and as such, the CRS/HIPEC method appears to be the more successful approach.
authors.affiliation: Dept. of General and Emergency Surgery, Ospedali Riuniti, Bergamo, Italy. fedecocco@iol.it
authors.forename: Federico
authors.initials: F
authors.lastname: Coccolini
authors.forename: Roberto
authors.initials: R
authors.lastname: Manfredi
authors.forename: Fausto
authors.initials: F
authors.lastname: Catena
authors.forename: Carlo
authors.initials: C
authors.lastname: Vallicelli
authors.forename: Pier Andrea
authors.initials: PA
authors.lastname: De Iaco
authors.forename: Andrea
authors.initials: A
authors.lastname: Martoni
authors.forename: Daniel
authors.initials: D
authors.lastname: Lazzareschi
authors.forename: Luca
authors.initials: L
authors.lastname: Ansaloni
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D018261:Mesothelioma, Cystic / Q000628:therapy*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D010534:Peritoneal Neoplasms / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents