Peritoneales Mesotheliom und Pseudomyxoma peritonei

Peritoneal mesothelioma and pseudomyxoma peritonei (PMP) are rare primary malignancies of the peritoneum. Prior to combined use of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), which may be a curative treatment option for these two diseases, they were long considered incurable and primarily treated palliatively. CRS-HIPEC combination therapy, used in specialized centers for peritoneal carcinomatosis, represents a fundamental component of the treatment modality and can significantly improve survival if completeness of cytoreduction (CC score) is given.

For the following work, we performed a review that included current literature on incidence, prognosis, staging, and systemic therapy options, and provided an overview of studies performed to date on CRS and HIPEC for peritoneal mesothelioma and PMP.

CRS-HIPEC can significantly improve survival in peritoneal mesothelioma and PMP, although individual prognosis may vary depending on histopathology. Specific algorithms and scoring systems are used in radiologic diagnosis and surgical procedures to aid prognostic assessment. The applied HIPEC regimens are heterogeneous, ranging from monotherapy to dual therapy and differing in terms of temporal duration. CRS-HIPEC without complications can lead to very good survival rates. However, if there is no reasonable operability, systemic medical oncologic treatment is an alternative that can be combined with palliative CRS-HIPEC.

Given their complexity, the treatment of peritoneal mesothelioma and PMP requires treatment in a specialized center and interdisciplinary collaboration. Very good results can be achieved using standard operating procedures (SOP). Randomized controlled trials of different HIPEC regimens are needed.