Malignant peritoneal mesothelioma: review of 25 patients.

Twenty-five patients with malignant peritoneal mesothelioma have been seen in Memorial Hospital since 1950. None of them had a history of exposure to asbestos and no clear etiologic factor could be determined in any of the patients. Two patients had signs of ectopic hormone production. The tumors tended to be locally invasive but distant hematogenous metastases were not seen in any of the patients. Surgery was not effective, as most patients had extensive intra-abdominal disease at the time of laparotomy. There were four long-term survivors. All of them were treated with external radiotherapy and 32P instillation after surgery. The response to chemotherapy was poor except for one partial response to combined therapy with adriamycin and radiation. Most patients died of extensive abdominal disease with a median survival of only 12 months.