*2.4.4 Recommendations in the treatment of MPM*

The recommendations discussed at the Washington DC 2016 meeting by the Peritoneal Surface Oncology Group International (PSOGI) regarding therapeutic strategies [39] in patients with MPM were the following:


**25**

*Peritoneal Mesothelioma: Clinical and Therapeutic Aspects*

There are still no clear recommendations in the follow-up of patients with MPM

Patients with peritoneal mesothelioma, due to nonspecific symptoms, present in advanced stages of the disease. An important role in determining the histological subtype of peritoneal mesothelioma is played by immunohistochemistry. Multidisciplinary management is preferred for patients with MPM. CRS and HIPEC appear to be the most effective therapeutic modalities in the treatment of MPM. Bidirectional chemotherapy is able to increase the resectability rate in patients with diffuse MPM, initially considered unresectable. Modern therapies such as molecular therapy and immunotherapy can increase the overall survival of patients with MPM. New therapeutic approaches have improved the prognosis only for patients in

after radical excision surgery [40]. There is a follow-up guide developed by the European Society for Medical Oncology for pleural mesothelioma, but no frequency or methods of investigation used in the postoperative period (CT, MRI, or ultrasonography) are specified. Serum follow-up markers are conventional: CA125 and

*DOI: http://dx.doi.org/10.5772/intechopen.93536*

mesothelin.

**2.5 Conclusions**

the early stages of the disease.

The authors declare no conflict of interest.

PM peritoneal mesothelioma

CRS cytoreductive surgery

PCI peritoneal cancer index

EGFR epidermal growth factor receptor

MPM malignant peritoneal mesothelioma

DMPM diffuse malignant peritoneal mesothelioma MCPM multicystic peritoneal mesothelioma BMPM benign multicystic peritoneal mesothelioma

PSOGI Peritoneal Surface Oncology Group International HIPEC hyperthermic intraperitoneal chemotherapy PIPAC pressurized intraperitoneal aerosol chemotherapy EPIC early postoperative intraperitoneal chemotherapy NIPEC normothermic intraperitoneal chemotherapy

**Conflict of interest**

**Abbreviations**

#### *Peritoneal Mesothelioma: Clinical and Therapeutic Aspects DOI: http://dx.doi.org/10.5772/intechopen.93536*

There are still no clear recommendations in the follow-up of patients with MPM after radical excision surgery [40]. There is a follow-up guide developed by the European Society for Medical Oncology for pleural mesothelioma, but no frequency or methods of investigation used in the postoperative period (CT, MRI, or ultrasonography) are specified. Serum follow-up markers are conventional: CA125 and mesothelin.
