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Therapeutic Strategies for Well-differentiated Papillary Mesothelioma of the Peritoneum

 Young Ki Lee  ;  Hyun Jung Jun  ;  Ji Hae Nahm  ;  Tae Seop Lim  ;  Ji Soo Park  ;  Joong Bae Ahn  ;  Sun Young Rha  ;  Hyun Cheol Chung  ;  Hwa Eun Oh  ;  Ji-Sun Song  ;  Woo Ick Yang  ;  Hyo Song Kim 
 JAPANESE JOURNAL OF CLINICAL ONCOLOGY, Vol.43(10) : 996-1003, 2013 
Journal Title
Issue Date
Adult ; Aged ; Antibodies, Monoclonal, Murine-Derived/analysis ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Biomarkers, Tumor/analysis* ; Calbindin 2 ; Chemotherapy, Adjuvant ; Cisplatin/administration & dosage ; Female ; Glutamates/administration & dosage ; Guanine/administration & dosage ; Guanine/analogs & derivatives ; Humans ; Immunohistochemistry ; Infusions, Intravenous ; Infusions, Parenteral ; Male ; Mesothelioma/chemistry ; Mesothelioma/diagnosis* ; Mesothelioma/drug therapy ; Mesothelioma/pathology ; Mesothelioma/surgery ; Mesothelioma/therapy* ; Middle Aged ; Multimodal Imaging ; Neoplasm Recurrence, Local/diagnosis ; Neoplasm Recurrence, Local/therapy ; Pemetrexed ; Peritoneal Neoplasms/chemistry ; Peritoneal Neoplasms/diagnosis* ; Peritoneal Neoplasms/drug therapy ; Peritoneal Neoplasms/pathology ; Peritoneal Neoplasms/surgery ; Peritoneal Neoplasms/therapy* ; Positron-Emission Tomography ; Prognosis ; Risk Factors ; S100 Calcium Binding Protein G/analysis ; Tomography, X-Ray Computed ; Treatment Outcome
chemotherapy ; cisplatin ; pemetrexed ; peritoneum ; therapeutic strategy ; well-differentiated papillary mesothelioma
OBJECTIVE: Well-differentiated papillary mesothelioma is an uncommon subtype of mesothelioma with a frequently indolent course, although it occasionally manifests in a more aggressive form. To establish a treatment strategy for this rare disease, we report the clinical characteristics and outcomes of 15 patients with well-differentiated papillary mesothelioma. METHODS: All pathologically diagnosed well-differentiated papillary mesothelioma cases were reviewed between 1998 and 2012. RESULTS: Of the 15 cases, 8 and 7 presented with single and multiple lesions, respectively. All cases with single lesions were asymptomatic, while 4 out of the 7 cases with multiple lesions were symptomatic. After tumor excision, none of the eight single-lesion cases experienced tumor recurrence. Among the other seven cases with multiple lesions, only one patient with disseminated lesions died due to disease burden. Five patients with multiple lesions received cisplatin-based intravenous or intraperitoneal chemotherapy, with a mix of complete (n= 2) and partial (n= 2) responses observed. Of particular note, one patient receiving cisplatin and pemetrexed combination chemotherapy experienced complete tumor resolution without any serious toxicity. CONCLUSIONS: We recommend different treatment strategies based on the disease status. If the tumor is completely resectable, an excisional biopsy seems to be sufficient. If complete resection is unavailable for the asymptomatic patient with a localized tumor extent, close follow-up is an appropriate option. When the tumor is extensive or accompanied by symptoms, chemotherapy should be strongly considered.
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1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hyo Song(김효송) ORCID logo https://orcid.org/0000-0002-0625-9828
Rha, Sun Young(라선영) ORCID logo https://orcid.org/0000-0002-2512-4531
Park, Ji Soo(박지수) ORCID logo https://orcid.org/0000-0002-0023-7740
Ahn, Joong Bae(안중배) ORCID logo https://orcid.org/0000-0001-6787-1503
Yang, Woo Ick(양우익) ORCID logo https://orcid.org/0000-0002-6084-5019
Lee, Young Ki(이영기)
Lim, Tae Seop(임태섭)
Chung, Hyun Cheol(정현철) ORCID logo https://orcid.org/0000-0002-0920-9471
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