title: Preventing recurrence of diffuse malignant peritoneal mesothelioma.
abstract: BACKGROUND
  Diffuse malignant peritoneal mesothelioma (DMPM) is an aggressive malignancy with a poor prognosis when treated with systemic therapy. Cytoreductive surgery (CRS) with intraperitoneal chemotherapy (IPC) is considered the best therapy in DMPM, but a high risk of locoregional recurrence remains.
  
  
  METHODS
  This review describes patient selection and operative goals with CRS and IPC, the reported outcomes with this approach, and the data supporting platinum-based IPC. We assess the pharmacokinetics supporting the use of dwell IPC. We outline clinical, imaging and laboratory surveillance for recurrence. In addition, we highlight the role of re-operation, both as a planned second procedure and in the context of disease recurrence. Literature review was performed via Medline search. Expert commentary: CRS/IPC offers survival benefit in selected patients with DMPM, but given the high rate of recurrence, close surveillance is needed post-operatively. Strategies to prevent and treat recurrent disease include dwell IPC and second CRS/IPC.
authors.affiliation: a Department of Surgery , Columbia University Medical Center , New York , NY , USA.
authors.forename: Joshua C
authors.initials: JC
authors.lastname: Leinwand
authors.affiliation: a Department of Surgery , Columbia University Medical Center , New York , NY , USA.
authors.forename: John A
authors.initials: JA
authors.lastname: Chabot
authors.affiliation: a Department of Surgery , Columbia University Medical Center , New York , NY , USA.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Kluger
mesh_terms: D000818:Animals; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D003131:Combined Modality Therapy; D065426:Cytoreduction Surgical Procedures / Q000379:methods; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000628:therapy*; D008654:Mesothelioma / Q000473:pathology / Q000628:therapy*; D000086002:Mesothelioma, Malignant; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000517:prevention & control*; D018579:Patient Selection; D010534:Peritoneal Neoplasms / Q000473:pathology / Q000628:therapy*; D011379:Prognosis; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents
keywords: Diffuse malignant peritoneal mesothelioma; cytoreductive surgery; intraperitoneal chemotherapy; recurrence; surveillance