Th? cancer of th? lining of the ?bd?min?l ??vit? i? called peritoneal m???th?li?m?. It i? not as common as ?l?ur?l form; it ??m?ri??? ?n estimated one fifth to ?n? third ?f ?ll di?gn???d m???th?li?m? ?????. Thi? r???rt ?f th? Surveillance, Epidemiology ?nd End R??ult? (SEER) ???r?xim?t?? th? number as 54.7% male ?nd 45.3% f?m?l?, with th? ?g? r?nging from 65 to 69. Th? period of l?t?n?? i? ?h?rt?r f?r ??ti?nt? ?x????d in ??b??t??, th? ??m?t?m? ?????ring ?ft?r 20 to 30 ???r? fr?m ?x???ur?; th? u?u?l l?t?n?? period f?r ?l?ur?l mesothelioma i? 30 t? 40 years.
P?rit?n??l Mesothelioma S?m?t?m?
At th? time ?f ?r???nt?ti?n, ??m?t?m? ?f ??rit?n??l mesothelioma includes ?bd?min?l mass, ?bd?min?l ??in, ?nl?rg?d ?bd?min?l girth, fluid in th? ?bd?m?n (???it??), di?t?nti?n of th? ?bd?m?n, w?ight loss, f?v?r, ?n?mi?, fatigue ?nd dig??tiv? di?turb?n???. F?r a f?w m?nth? before a ??nfirm?d di?gn??i?, some patients ?v?n ??m?l?in of ??m?t?m? that ?r? non-specific. In?id?nt?ll?, ??rit?n??l m???th?li?m? i? found in a ??r??nt?g? ?f cases ?n?? th? patient has ?th?r h??lth ??m?l?int? such ?? hernia, g?llbl?dd?r or pelvic mass.
D??t?r? wh? h?v? experiences in this fi?ld have noted th?t t??i??ll?, patients h?v? these ??m?t?m? ?ix m?nth? to tw? years ?ri?r t? the di?gn??i?. M?n ?ft?n ??m? t? th? d??t?r ??m?l?ining ?f a bulg? in th? groin (h?rni?) ?r around th? b?ll? butt?n (umbilical h?rni?). F?r women, th? fir?t ?ign ?f a ?r?bl?m often ???ur? ?ft?r a ??lvi? test wh?n a tum?r m??? h?v? b??n di???v?r?d.
In later ?t?g?? of ??rit?n??l m???th?li?m?, ?m?ng th? symptoms are increased ???urr?n??? ?f bl??d clots ?nd ?b?tru?ti?n ?f th? b?w?l. Th?r? i? a n?ti???bl? in?r???? ?n th? platelet ??unt for 50% of peritoneal ??ti?nt? but this m?? b? caused b? v?ri?u? di??rd?r?, ?? this i? actually of littl? h?l? in the di?gn??i?. Low ?lbumin level and ?n?mi? ??n ?l?? b? ?m?ng th? ??m?t?m?.
P?rit?n??l Mesothelioma Di?gn??i?
P?rit?n??l mesothelioma h?? tw? ?lini??l types which ??n b? diff?r?nti?t?d with the help ?f CT finding?, th? "dr?" t??? ?nd th? "w?t". It is ?l???ifi?d ?? "dr?" when th?r? are multiple tin? masses ?r ?n? d?min?nt l???liz?d m??? and g?n?r?ll? littl? ?r n? ???it??. The "w?t" t??? h?? wid???r??d small n?dul??, no d?min?nt m??? ?nd a presence ?f ascites.
If fluid i? f?und, th? process ?f ?limin?ting it is thr?ugh ??r???nt??i?; however th? ?n?l??i? ?f thi? fluid h?? limit?d diagnostic ?ignifi??n??. N?rm?ll?, a definitive di?gn??i? m?? b? obtained through ti??u? biopsy.
Staging
A? th?r? i? ?urr?ntl? n? ?t?ging ???t?m f?r peritoneal m???th?li?m?, the most ???ul?r system f?r general ??n??r ?t?ging (TNM ???t?m) is used. TNM ???t?m h?? th? following criteria: (T) ?t?tu? ?f the tum?r, (N) l?m?h n?d?? and (M) metastases. Oth?r g?n?r?l ??t?g?ri?? may ?l?? be helpful in order to determine th? ?t?g?.
Category 1 - with a localized l??i?n th?t ??n entirely b? removed (r????t?d)
C?t?g?r? 2 - th? disease i? l???t?d in?id? th? abdominal cavity ?n ??rit?n??l or ?rg?n ?urf???? where th?r? is a ?r?b?bilit? ?f removing ?? mu?h tumor ?? possible (debulking)
C?t?g?r? 3 - the di????? is located inside the ?bd?min?l cavity and invades ?rg?n? such ?? liver ?r colon.
C?t?g?r? 4 - th? di????? ?xt?nd? ?ut?id? ?f th? abdominal ??vit?
P?rit?n??l M???th?li?m? Tr??tm?nt
In the ???t ???r?, the ?ff??tiv?n??? of surgery ?l?n? ?r intr???rit?n??l chemotherapy in th? tr??tm?nt ?f ??rit?n??l m???th?li?m? were n?t proven, that i? wh? multim?d?lit? treatment is becoming more popular. Debulking (??t?r?du?tiv?) ?urg?r? i? r?m?ving ?ll or n??rl? ?ll visible tum?r? ?nd m?? b? ??mbin?d with IPHC (Intra-Peritoneal H???rth?rmi? Chemotherapy), intr???rit?n??l ?h?m?th?r??? ?nd r?di?ti?n.
R?m?ving all tum?r? is not ?lw??? probable; th? ?r?gn??i? for ?urviv?l ??n th?n b? in accordance with the completeness of ??t?r?du?ti?n whi?h i? established b? th??? criteria:
C?m?l?t? cytoreduction
(CC-0): No ??rit?n??l ???ding i? f?und within th? ???r?tiv? ?r???
(CC-1): Nodules less than 2.5 ?m ??rri?? ?n ?ft?r cytoreduction whi?h can b? ??n?tr?t?d b? intr?-??vit? ?h?m?th?r???; thu? th? ?r????? i? t?rm?d complete.
Incomplete ??t?r?du?ti?n
(CC-2) N?dul?? with ?iz?? of 2.5 t? 5 cm ??rr? ?n ?ft?r ??t?r?du?ti?n
(CC-3) N?dul?? th?t ?r? larger than 5 cm ?r? f?und; ?r there i? a merging ?f tumor n?dul?? th?t ?r? unresectable ?t ?n? area within the ??lvi? ?r ?bd?m?n.
S?m? patients m?? h?v? wid???r??d di????? wh?r? ?urg?r? i? n?t considered as "??t?nti?ll? ?ur?tiv?", ??lli?tiv? tr??tm?nt may be d?n? b? d?bulking. T?k? n?t? th?t ????i?liz?d tr??tm?nt? ?h?uld only be administered b? ?????n?d d??t?r? b???u?? ??rit?n??l m???th?li?m? i? a rare malignant di?????.
R???ntl?, a ?lini??l trial di???v?r?d Alimt? (??m?tr?x?d) t? b? ?ff??tiv? ?? ?h?m?th?r??? ?g?nt ?n tr??ting peritoneal m???th?li?m?, ?ith?r on it? ?wn ?r ??mbin?d with cisplatin or ?n? platinum-based drug. Thi? r?fl??t? the previous finding? r?g?rding pemetrexed medication of pleural m???th?li?m?.
For m?r? inf?rm?ti?n ?n Peritoneal Mesothelioma ?r any ?th?r t??? of M???th?li?m? C?n??r a good inf?rm?ti?n ?it? i? Mesothelioma Symptoms, wh?r? all r?l??v?nt topics are discussed. Some example t??i?? include M???th?li?m? tr??tm?nt, M???th?li?m? C?m??n??ti?n, M???th?li?m? statistics, ???ing with M???th?li?m? ?nd causes of M???th?li?m?. A f?rum i? also ?v?ilbl? t? di??u?? ?n? t??i?? with ?ur experts.
P?rit?n??l Mesothelioma S?m?t?m?
At th? time ?f ?r???nt?ti?n, ??m?t?m? ?f ??rit?n??l mesothelioma includes ?bd?min?l mass, ?bd?min?l ??in, ?nl?rg?d ?bd?min?l girth, fluid in th? ?bd?m?n (???it??), di?t?nti?n of th? ?bd?m?n, w?ight loss, f?v?r, ?n?mi?, fatigue ?nd dig??tiv? di?turb?n???. F?r a f?w m?nth? before a ??nfirm?d di?gn??i?, some patients ?v?n ??m?l?in of ??m?t?m? that ?r? non-specific. In?id?nt?ll?, ??rit?n??l m???th?li?m? i? found in a ??r??nt?g? ?f cases ?n?? th? patient has ?th?r h??lth ??m?l?int? such ?? hernia, g?llbl?dd?r or pelvic mass.
D??t?r? wh? h?v? experiences in this fi?ld have noted th?t t??i??ll?, patients h?v? these ??m?t?m? ?ix m?nth? to tw? years ?ri?r t? the di?gn??i?. M?n ?ft?n ??m? t? th? d??t?r ??m?l?ining ?f a bulg? in th? groin (h?rni?) ?r around th? b?ll? butt?n (umbilical h?rni?). F?r women, th? fir?t ?ign ?f a ?r?bl?m often ???ur? ?ft?r a ??lvi? test wh?n a tum?r m??? h?v? b??n di???v?r?d.
In later ?t?g?? of ??rit?n??l m???th?li?m?, ?m?ng th? symptoms are increased ???urr?n??? ?f bl??d clots ?nd ?b?tru?ti?n ?f th? b?w?l. Th?r? i? a n?ti???bl? in?r???? ?n th? platelet ??unt for 50% of peritoneal ??ti?nt? but this m?? b? caused b? v?ri?u? di??rd?r?, ?? this i? actually of littl? h?l? in the di?gn??i?. Low ?lbumin level and ?n?mi? ??n ?l?? b? ?m?ng th? ??m?t?m?.
P?rit?n??l Mesothelioma Di?gn??i?
P?rit?n??l mesothelioma h?? tw? ?lini??l types which ??n b? diff?r?nti?t?d with the help ?f CT finding?, th? "dr?" t??? ?nd th? "w?t". It is ?l???ifi?d ?? "dr?" when th?r? are multiple tin? masses ?r ?n? d?min?nt l???liz?d m??? and g?n?r?ll? littl? ?r n? ???it??. The "w?t" t??? h?? wid???r??d small n?dul??, no d?min?nt m??? ?nd a presence ?f ascites.
If fluid i? f?und, th? process ?f ?limin?ting it is thr?ugh ??r???nt??i?; however th? ?n?l??i? ?f thi? fluid h?? limit?d diagnostic ?ignifi??n??. N?rm?ll?, a definitive di?gn??i? m?? b? obtained through ti??u? biopsy.
Staging
A? th?r? i? ?urr?ntl? n? ?t?ging ???t?m f?r peritoneal m???th?li?m?, the most ???ul?r system f?r general ??n??r ?t?ging (TNM ???t?m) is used. TNM ???t?m h?? th? following criteria: (T) ?t?tu? ?f the tum?r, (N) l?m?h n?d?? and (M) metastases. Oth?r g?n?r?l ??t?g?ri?? may ?l?? be helpful in order to determine th? ?t?g?.
Category 1 - with a localized l??i?n th?t ??n entirely b? removed (r????t?d)
C?t?g?r? 2 - th? disease i? l???t?d in?id? th? abdominal cavity ?n ??rit?n??l or ?rg?n ?urf???? where th?r? is a ?r?b?bilit? ?f removing ?? mu?h tumor ?? possible (debulking)
C?t?g?r? 3 - the di????? is located inside the ?bd?min?l cavity and invades ?rg?n? such ?? liver ?r colon.
C?t?g?r? 4 - th? di????? ?xt?nd? ?ut?id? ?f th? abdominal ??vit?
P?rit?n??l M???th?li?m? Tr??tm?nt
In the ???t ???r?, the ?ff??tiv?n??? of surgery ?l?n? ?r intr???rit?n??l chemotherapy in th? tr??tm?nt ?f ??rit?n??l m???th?li?m? were n?t proven, that i? wh? multim?d?lit? treatment is becoming more popular. Debulking (??t?r?du?tiv?) ?urg?r? i? r?m?ving ?ll or n??rl? ?ll visible tum?r? ?nd m?? b? ??mbin?d with IPHC (Intra-Peritoneal H???rth?rmi? Chemotherapy), intr???rit?n??l ?h?m?th?r??? ?nd r?di?ti?n.
R?m?ving all tum?r? is not ?lw??? probable; th? ?r?gn??i? for ?urviv?l ??n th?n b? in accordance with the completeness of ??t?r?du?ti?n whi?h i? established b? th??? criteria:
C?m?l?t? cytoreduction
(CC-0): No ??rit?n??l ???ding i? f?und within th? ???r?tiv? ?r???
(CC-1): Nodules less than 2.5 ?m ??rri?? ?n ?ft?r cytoreduction whi?h can b? ??n?tr?t?d b? intr?-??vit? ?h?m?th?r???; thu? th? ?r????? i? t?rm?d complete.
Incomplete ??t?r?du?ti?n
(CC-2) N?dul?? with ?iz?? of 2.5 t? 5 cm ??rr? ?n ?ft?r ??t?r?du?ti?n
(CC-3) N?dul?? th?t ?r? larger than 5 cm ?r? f?und; ?r there i? a merging ?f tumor n?dul?? th?t ?r? unresectable ?t ?n? area within the ??lvi? ?r ?bd?m?n.
S?m? patients m?? h?v? wid???r??d di????? wh?r? ?urg?r? i? n?t considered as "??t?nti?ll? ?ur?tiv?", ??lli?tiv? tr??tm?nt may be d?n? b? d?bulking. T?k? n?t? th?t ????i?liz?d tr??tm?nt? ?h?uld only be administered b? ?????n?d d??t?r? b???u?? ??rit?n??l m???th?li?m? i? a rare malignant di?????.
R???ntl?, a ?lini??l trial di???v?r?d Alimt? (??m?tr?x?d) t? b? ?ff??tiv? ?? ?h?m?th?r??? ?g?nt ?n tr??ting peritoneal m???th?li?m?, ?ith?r on it? ?wn ?r ??mbin?d with cisplatin or ?n? platinum-based drug. Thi? r?fl??t? the previous finding? r?g?rding pemetrexed medication of pleural m???th?li?m?.
For m?r? inf?rm?ti?n ?n Peritoneal Mesothelioma ?r any ?th?r t??? of M???th?li?m? C?n??r a good inf?rm?ti?n ?it? i? Mesothelioma Symptoms, wh?r? all r?l??v?nt topics are discussed. Some example t??i?? include M???th?li?m? tr??tm?nt, M???th?li?m? C?m??n??ti?n, M???th?li?m? statistics, ???ing with M???th?li?m? ?nd causes of M???th?li?m?. A f?rum i? also ?v?ilbl? t? di??u?? ?n? t??i?? with ?ur experts.