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Background <p>Treatment of peritoneal mesothelioma (PeM) poses significant challenges owing to its rare incidence, heterogeneity, and limited clinical evidence. This manuscript describes results from a national consensus aimed at addressing management of PeM.</p> Methods <p>An update of the 2018 Chicago Consensus Guidelines was conducted using a Modified Delphi technique, encompassing two rounds of voting. The levels of agreement for various pathway blocks were assessed.</p> Results <p>Of 101 participants responding in the first round of Modified Delphi voting, 95 (94%) responded in the second round. Over 90% consensus was achieved in 5/6 and 6/6 pathway blocks in rounds I and II, respectively. Observation was recommended for benign neoplasms, with guidance for interventions in the presence of symptoms or concerning clinicopathologic features. For malignant pathology, management was outlined based on a multidisciplinary assessment of patient characteristics, disease histology, and predictive success of medical and surgical interventions. Additional emphasis was placed on multimodal therapy for Intermediate-Risk and appropriate High-Risk patients. A rapid review demonstrated limited availability of data and inconclusive findings regarding optimal systemic therapy timing. There was unanimous support for considering clinical trial enrollment.</p> Conclusions <p>Given limited evidence, the consensus-driven pathway provides essential guidance regarding the management of PeM. To further direct clinical care, additional dedicated research to generate higher-quality evidence is needed.</p>

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Consensus Guideline for the Management of Peritoneal Mesothelioma

  • 期刊论文

  • 发表日期：

    2025年6月25日

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  • Leanne M. Brown,
  • Sarah G. Wilkins,
  • Varun V. Bansal,
  • David G. Su,
  • Jorge Gomez-Mayorga,
  • Kiran K. Turaga,
  • Craig G. Gunderson,
  • Byrne Lee,
  • Garrett M. Nash,
  • John L. Hays,
  • Kanwal P. Raghav,
  • Aliya L. Husain,
  • Michael D. Kluger,
  • Marjorie G. Zauderer,
  • Hedy L. Kindler,
  • H. Richard Alexander,
  • Aaron Mansfield,
  • Adam Khader,
  • Ahmed Hamed,
  • Alberto Marchevsky,
  • Alda Tam,
  • Alex Fisher,
  • Alex Kim,
  • Alexander Loftus,
  • Alexander S. Thomas,
  • Alexandra Gangi,
  • Alicia Greene,
  • Alissa Greenbaum,
  • Amanda Arrington,
  • Anai Kothari,
  • Anand Govindarajan,
  • Andrei Nikiforchin,
  • Andres Abreu,
  • Andrew Blakely,
  • Andrew Churg,
  • Andrew Łowy,
  • Andrew M. Bellizzi,
  • Andrew Nicholson,
  • Ankit Dhiman,
  • Anthony Villano,
  • Antoine Bouchard-Fortier,
  • Anwaar Saeed,
  • Armando Sardi,
  • Baylee Bakkila,
  • Beatrice Sun,
  • Benjamin Powers,
  • Beth Helmink,
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  • Bradley White,
  • Brian Sparkman,
  • Caitlin Hester,
  • Carla Harmath,
  • Carlos Chan,
  • Carrie Luu,
  • Charles Staley,
  • Chukwuemeka Ihemelandu,
  • Colette Brottman,
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  • Colin Court,
  • Conor O’Neill,
  • Dan Blazer,
  • Daniel Abbott,
  • Daniel Labow,
  • Daniel Milgrom,
  • Darryl Outlaw,
  • Darryl Schuitevoerder,
  • David B. Chapel,
  • David Bartlett,
  • David Hanna,
  • David Ilson,
  • Deepa Magge,
  • Marcello Deraco,
  • Devon Freudenberger,
  • Deyali Chatterjee,
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  • Emily Papai,
  • Emmanuel Gabriel,
  • Eric Pletcher,
  • Erin P. Ward,
  • Fabian Johnston,
  • Felipe Lopez-Ramirez,
  • Forest Mahoney,
  • Francisco Izquierdo,
  • Frederick A. Godley,
  • Gary N. Mann,
  • George Salti,
  • Georgios Georgakis,
  • Georgios Karagkounis,
  • Gilbert Murimwa,
  • Giorgos Karakousis,
  • Hallbera Gudmundsdottir,
  • Hanna Sanoff,
  • Harveshp Mogal,
  • Hunter Witmer,
  • Ioannis Konstantinidis,
  • Jackson Baril,
  • Jacquelyne J. Gaddy,
  • James Cusack Campbell Jr,
  • Jane Wang,
  • Jason Foster,
  • Jason L. Hornick,
  • Javid Sadjadi,
  • Jeff Sussman,
  • Jeffrey M. Sutton,
  • Jennifer Keller,
  • Jeremy Sharib,
  • Jesus Esquivel,
  • Joanna Buchheit,
  • Joel Baumgartner,
  • John Miura,
  • John Paul Shen,
  • Jonathan B. Greer,
  • Jonathan Dowell,
  • Joseph Kim,
  • Joshua Winer,
  • Jula Veerapong,
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  • Lauren Raymond,
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  • Madeline B. Torres,
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  • Maria Russell,
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  • Mazin Al-Kasspooles,
  • Mecker Moller,
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  • Melanie Ongchin,
  • Melissa Taggart,
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  • Mohammed Suraju,
  • Mojgan Hosseini,
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  • Nabil Wasif,
  • Nadège Fackche,
  • Nader Hanna,
  • Neal Bhutiani,
  • Nelya Melnitchouk,
  • Niraj J. Gusani,
  • Oliver Eng,
  • Olivier Glehen,
  • Pathik Aravind,
  • Patricio Polanco,
  • Patrick Wagner,
  • Paul Helft,
  • Paul Sugarbaker,
  • Pompiliu Piso,
  • Prakash Pandalai,
  • Rachel Kim,
  • Rachyl Shanker,
  • Raed Al-Rajabi,
  • Raghav Sundar,
  • Rajiv Agarwal,
  • Randall Zuckerman,
  • Rebecca Wiatrek,
  • Ricardo Bello,
  • Richard Attanoos,
  • Richard Berri,
  • Richard Hoehn,
  • Richard Royal,
  • Riom Kwakman,
  • Rita Akumuo,
  • Robert Barone,
  • Robert Sticca,
  • Rudy Lackner,
  • Rupen Shah,
  • Ryan Merkow,
  • Sabha Ganai,
  • Sam George Pappas,
  • Samantha Ruff,
  • Sameer Patel,
  • Samer Naffouje,
  • Samuel Butensky,
  • Sanjay Bagaria,
  • Sara Daniel,
  • Scott Sherman,
  • Sean Dineen,
  • Seth J. Concors,
  • Shannon Radomski,
  • Sherif Abdel-Misih,
  • Soo Ryum Yang,
  • Stacey Cohen,
  • Stephanie Greco,
  • Steven Libutti,
  • Susan Campbell,
  • T. Clark Gamblin,
  • Taylor Jaraczewski,
  • Thinzar Lwin,
  • Travis Grotz,
  • Ugwuji Maduekwe,
  • Umut Sarpel,
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  • Xiang Gao,
  • Yan Li

摘要

Background

Treatment of peritoneal mesothelioma (PeM) poses significant challenges owing to its rare incidence, heterogeneity, and limited clinical evidence. This manuscript describes results from a national consensus aimed at addressing management of PeM.

Methods

An update of the 2018 Chicago Consensus Guidelines was conducted using a Modified Delphi technique, encompassing two rounds of voting. The levels of agreement for various pathway blocks were assessed.

Results

Of 101 participants responding in the first round of Modified Delphi voting, 95 (94%) responded in the second round. Over 90% consensus was achieved in 5/6 and 6/6 pathway blocks in rounds I and II, respectively. Observation was recommended for benign neoplasms, with guidance for interventions in the presence of symptoms or concerning clinicopathologic features. For malignant pathology, management was outlined based on a multidisciplinary assessment of patient characteristics, disease histology, and predictive success of medical and surgical interventions. Additional emphasis was placed on multimodal therapy for Intermediate-Risk and appropriate High-Risk patients. A rapid review demonstrated limited availability of data and inconclusive findings regarding optimal systemic therapy timing. There was unanimous support for considering clinical trial enrollment.

Conclusions

Given limited evidence, the consensus-driven pathway provides essential guidance regarding the management of PeM. To further direct clinical care, additional dedicated research to generate higher-quality evidence is needed.