{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T23:59:55Z","timestamp":1789171195490,"version":"build-2803163510"},"reference-count":92,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,1,21]],"date-time":"2023-01-21T00:00:00Z","timestamp":1674259200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"RanD corporation"},{"name":"AIRC (Italian Association for Cancer Research)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Diffuse malignant peritoneal mesothelioma (DMPM) is a rare form of mesothelioma that carries a very poor prognosis. The 5-year overall survival is about 20% (\u00b15.9). Survival is optimal for patients suitable for cytoreductive surgery (CRS) with Hyperthermic Intraperitoneal Chemotherapy (HIPEC), with a median OS ranging from 34 to 92 months. However, selecting patients for surgery remains a complex task and requires a careful preoperative workup, rational analysis of prognostic profiles, and risk prediction models. Systemic chemotherapy could be offered: (1) in the adjuvant setting for high-risk patients; (2) for patients not eligible for CRS; and (3) for those with recurrent disease. It mainly includes the combination of Platin compound with Pemetrexed or immunotherapy. The biology of DMPM is still largely unknown. However, progress has been made on some fronts, such as telomere maintenance mechanisms, deregulation of apoptosis, tyrosine kinase pathways, and mutation of BRCA1-associated protein 1 (BAP1). Future perspectives should include translational research to improve our understanding of the disease biology to identify druggable targets. We should also clear the role of immune checkpoint inhibitors and investigate new locoregional technologies, such as pressurized intraperitoneal aerosol chemotherapy (PIPAC) or normothermic intraperitoneal chemotherapy (NIPEC).<\/jats:p>","DOI":"10.3390\/cancers15030662","type":"journal-article","created":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T04:19:22Z","timestamp":1674447562000},"page":"662","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Diagnostic and Therapeutic Pathway in Diffuse Malignant Peritoneal Mesothelioma"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3116-277X","authenticated-orcid":false,"given":"Shigeki","family":"Kusamura","sequence":"first","affiliation":[{"name":"Peritoneal Surface Malignancies Unit, Fondazione Istituto Nazionale dei Tumori IRCCS Milano, 20133 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario","family":"Baratti","sequence":"additional","affiliation":[{"name":"Peritoneal Surface Malignancies Unit, Fondazione Istituto Nazionale dei Tumori IRCCS Milano, 20133 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"De Simone","sequence":"additional","affiliation":[{"name":"Candiolo Cancer Institute, FPO\u2014IRCCS, 10060 Candiolo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico Maria","family":"Pasqual","sequence":"additional","affiliation":[{"name":"AOUD Center Advanced Surgical Oncology, DAME University of Udine, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Ansaloni","sequence":"additional","affiliation":[{"name":"Unit of General Surgery, San Matteo Hospital, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2066-1618","authenticated-orcid":false,"given":"Daniele","family":"Marrelli","sequence":"additional","affiliation":[{"name":"Unit of General Surgery and Surgical Oncology, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7676-9658","authenticated-orcid":false,"given":"Manuela","family":"Robella","sequence":"additional","affiliation":[{"name":"Candiolo Cancer Institute, FPO\u2014IRCCS, 10060 Candiolo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Accarpio","sequence":"additional","affiliation":[{"name":"CRS and HIPEC Unit, Pietro Valdoni, Umberto I Policlinico di Roma, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Valle","sequence":"additional","affiliation":[{"name":"Peritoneal Tumours Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6838-8318","authenticated-orcid":false,"given":"Stefano","family":"Scaringi","sequence":"additional","affiliation":[{"name":"IBD Unit, DEA AOU Careggi, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Biacchi","sequence":"additional","affiliation":[{"name":"CRS and HIPEC Unit, Pietro Valdoni, Umberto I Policlinico di Roma, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Palopoli","sequence":"additional","affiliation":[{"name":"U.O.C.\u2014P.S.G. con O.B.I. Azienda Ospedaliera Universitaria \u201cG. Martino\u201d, 98125 Messina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Gazzanelli","sequence":"additional","affiliation":[{"name":"CRS and HIPEC Unit, Pietro Valdoni, Umberto I Policlinico di Roma, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8194-9810","authenticated-orcid":false,"given":"Marcello","family":"Guaglio","sequence":"additional","affiliation":[{"name":"Peritoneal Surface Malignancies Unit, Fondazione Istituto Nazionale dei Tumori IRCCS Milano, 20133 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello","family":"Deraco","sequence":"additional","affiliation":[{"name":"Peritoneal Surface Malignancies Unit, Fondazione Istituto Nazionale dei Tumori IRCCS Milano, 20133 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2671","DOI":"10.1007\/s00432-021-03533-6","article-title":"Clinicopathological Characteristics and Outcomes in Men with Mesothelioma of the Tunica Vaginalis Testis: Analysis of Published Case-Series Data","volume":"147","author":"Grogg","year":"2021","journal-title":"J. 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