Malignant Abdominal Mesothelioma: Defining the Role of Surgery

Objective: Determine the role of surgery for patients with malignant abdominal mesotheliomas (MAMs). Methods: The Surveillance, Epidemiology, and End Results (SEER) database (1973-2005) was queried. Results: Overall, 10,589 cases of malignant mesotheliomas were identified. Of these, 9,211 cases were thoracic (TM) and 1,112 cases were MAM (10.5%). Patients with TM presented with more localized disease than those patients with MAM (P<0.001). MAM more often affected younger patients (63 years vs. 71 years) (P<0.001). The annual incidence of MAM was approximately 1.00 case per 100,000 in 2005. Overall median survival for MAM patients was 8 months, with a significant difference between women and men (13 months vs. 6 months, respectively) (P<0.001). Patients who successfully underwent surgical resection had a considerably longer median survival (20 months vs. 4 months, P<0.001) as well as a significantly higher5-year survival (28% vs. 12%, P<0.001). Multivariate analysis identified that a poorly differentiated tumor grade, failure to undertake surgical resection, advanced age, and male gender were all independent predictors of poorer outcome. Conclusion: Surgical extirpation of MAM may be associated with significantly improved Survival. All patients with MAM should be evaluated for potential surgical resection.