Introduction Diffuse malignant peritoneal mesothelioma (DMPM) is a rare and aggressive cancer that originates in the peritoneum. Due to its poor prognosis, a better understanding of its clinical characteristics and prognostic factors is needed. This study aimed to investigate such factors and their association with survival in patients with DMPM.

Methods We conducted a retrospective analysis of patients diagnosed with DMPM at Ajou University Hospital from February 2000 to June 2022. Various clinical characteristics and potential risk factors that may influence survival were evaluated.

Results We identified a total of 22 patients (6 male, 16 female) with DMPM. The median age of the patients was 57.5 years (range 20–80). The overall median survival was 31.1 months (95% CI 15.8–46.4), with a 5-year survival rate of 25.3%. Of the patients, 2 received cytoreductive surgery and followed by adjuvant chemotherapy, 4 received cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy (CRS+HIPEC). Survival analysis revealed that cytoreductive surgery (p=0.014) and intraperitoneal chemotherapy (p=0.008) were significantly associated with overall survival.

Conclusion/Implications Our findings suggest that cytoreductive surgery and intraperitoneal chemotherapy are important treatment options for improving survival in patients with DMPM. Further research is needed to better understand the optimal treatment approach for this rare and aggressive cancer.