Diffuse Malignant Mesothelioma of the Peritoneum
A Clinicopathologic Study of 35 Patients Treated Locoregionally at a Single
Daisuke Nonaka, M.D.1
Shigeki Kusamura, M.D.2
Dario Baratti, M.D.2
Paolo Casali, M.D.3
Antonello Domenico Cabras, M.D.1
Rami Younan, M.D.4
Juan Rosai, M.D.1
Marcello Deraco, M.D.2
1 Department of Pathology, National Cancer Insti-
tute, Milan, Italy.
2 Department of Surgery, National Cancer Institute,
3 Department of Medical Oncology, National Can-
cer Institute, Milan, Italy.
4 Department of Surgery Centre Hospitalier de
l’Universite de Montreal
(CHUM), University of
Montreal Academic Hospital, Montreal, Quebec,
Address for reprints: Daisuke Nonaka, M.D., De-
partment of Pathology, New York University Med-
ical Center, Tisch Hospital (TH-461), 560 First
Avenue, New York, NY 10016; Fax: (212) 263-
5509; E-mail: email@example.com
Received December 6, 2004; revision received
March 11, 2005; accepted March 25, 2005.
BACKGROUND. In the current study, the authors report the clinicopathologic fea-
tures of patients with peritoneal diffuse malignant mesothelioma (DMM) who were
treated in a uniform fashion at a single institution to assess prognostic factors.
METHODS. Thirty-five patients were treated with cytoreductive surgery (CRS) and
intraperitoneal hyperthermic perfusion (IPHP). The tumors were classified into
epithelial, sarcomatoid, and biphasic types. Immunohistochemistry stains were
performed for calretinin, WT-1, pCEA, Ber-EP4, epidermal growth factor receptor
(EGFR), p16, matrix metalloprotease-2 (MMP-2), and MMP-9. Statistical correla-
tion was evaluated for age, gender, completeness of cytoreduction (CC), tumor
histotype, mitotic count (MC), necrosis, nuclear grade (NG), and biologic markers
with regard to overall survival (OS) and progression-free survival (PFS).
RESULTS. The patient group was comprised of 15 men and 20 women with a
median age of 52 years (range, 24–73 yrs). Twenty-five patients underwent optimal
cytoreduction. There were 32 e