title: Advances in malignant peritoneal mesothelioma.
abstract: BACKGROUND
  Malignant mesothelioma is a rare, insidious, and aggressive tumor arising from the mesothelial surface of pleural and peritoneal cavities, the pericardium, or the tunica vaginalis, with an increasing incidence worldwide, high misdiagnosis rate, and overall negative prognosis. A total of 20% of all cases is peritoneum in origin.
  
  
  METHODS
  The present study is a review of literatures focusing on the advances in epidemiology, clinical presentations, radiological features, diagnosis, misdiagnosis, management, and prognostic factors of malignant peritoneal mesothelioma (MPM) occurred in the past decades.
  
  
  RESULTS
  Asbestos, SV40, and radiation exposures have been demonstrated to be correlated with the pathogenesis of MPM. The main presentations are abdominal distension and pain. Computed tomography (CT), magnetic resonance imaging (MRI), and positron-emission tomography (PET) play an important role in the preoperative imaging and staging. Definitive diagnosis is made on the basis of immunohistochemistry. Prognostic factors have been identified and verified. Negative indicators include advanced age, male gender, poor performance status, non-epithelial histology, and absence of surgery. The management of MPM has evolved from single chemotherapy to multimodality treatment of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), chemotherapy, radiotherapy, and immunotherapy. Promising results have been achieved after a combined treatment of CRS and HIPEC, with an elevated median survival time of 29.5-92 months and a 5-year survival rate of 39-63%.
  
  
  CONCLUSIONS
  CRS and HIPEC represent the standard treatment strategy for selected patients with MPM, and patients with unresectable tumors can benefit from the combined treatment of chemotherapy, radiotherapy, and immunotherapy.
authors.affiliation: Department of Medical Oncology, Harbin Medical University Cancer Hospital, No.150 Haping Road, Harbin, 150081, China, cs.bo@163.com.
authors.forename: Shoubo
authors.initials: S
authors.lastname: Cao
authors.forename: Shi
authors.initials: S
authors.lastname: Jin
authors.forename: Jingyan
authors.initials: J
authors.lastname: Cao
authors.forename: Jing
authors.initials: J
authors.lastname: Shen
authors.forename: Jing
authors.initials: J
authors.lastname: Hu
authors.forename: Dehai
authors.initials: D
authors.lastname: Che
authors.forename: Bo
authors.initials: B
authors.lastname: Pan
authors.forename: Jiawen
authors.initials: J
authors.lastname: Zhang
authors.forename: Xiaoxi
authors.initials: X
authors.lastname: He
authors.forename: Dian
authors.initials: D
authors.lastname: Ding
authors.forename: Feifei
authors.initials: F
authors.lastname: Gu
authors.forename: Yan
authors.initials: Y
authors.lastname: Yu
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D008297:Male; D008654:Mesothelioma / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D000086002:Mesothelioma, Malignant; D010534:Peritoneal Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D011379:Prognosis