Ullah Asad, Waheed Abdul, Khan Jaffar, Mishra Ankita, Tareen Bisma, Nama Noor, Karki Nabin Raj, Panezai Muhammad Saleem, Zarate Luis Velasquez, White Joseph, Cason Frederick D, Matolo Nathaniel, Misra Subhasis, Karim Nagla Abdel
Georgia Cancer Center, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA.
Department of Surgery, San Joaquin General Hospital, French Camp, CA 95231, USA.
Cancers (Basel). 2022 Feb 14;14(4):942. doi: 10.3390/cancers14040942.
Primary peritoneal mesothelioma (PPM) is a rare and aggressive tumor arising from the visceral and parietal peritoneum. The diagnosis and treatment of PPM are often delayed because of non-specific clinical presentation, and the prognosis is worse. The current study investigated the demographic, clinical, and pathological factors affecting patient prognosis and survival in PPM.
Demographic and clinical data of 1998 patients with PPM were extracted from the Surveillance Epidemiology and End Results (SEER) database (1975-2016). The chi-square test, paired -test, and multivariate analysis were used to analyze the data.
The majority of PPM patients were male (56.2%, < 0.005) and Caucasian (90.4%, < 0.005, with a mean age of diagnosis was 69 ± 13 years. The grading, histological, and tumor size information were classified as "Unknown" in most of the cases, but when available, poorly differentiated tumors (8.7%), malignant mesothelioma, not otherwise specified (63.4%) and tumors > 4 cm in size (8%), respectively, were most common, < 0.005. Chemotherapy was administered to 50.6% of patients, followed by resection (29.2%) and radiation (1.5%), < 0.001. The cohort of PPM had a five-year overall survival of 20.3% (±1.1), compared to 43.5% (±5.9), 25.9% (± 8.4), and 18.7% (±1.6) for those with surgery, radiation, or chemotherapy alone, respectively. Poor differentiation (OR = 4.2, CI = 3.3-4.9), tumor size > 4 cm (OR = 3.9, CI = 3.2-4.5), Caucasian race (OR = 2.9, CI = 2.6-4.4), and distant SEER stage (OR = 2.5, CI = 1.1-3.2) were all linked with increased mortality ( < 0.001).
An extremely rare and aggressive peritoneal tumor, PPM may be difficult to identify at the time of diagnosis. Radiation therapy likely to have a limited function in the treatment of this condition, with surgery and chemotherapy being the primary choices. All PPM patients should be enrolled in a nationwide registry to improve our understanding of the pathogenesis and identify factors affecting survival.
原发性腹膜间皮瘤（PPM）是一种罕见的侵袭性肿瘤，起源于脏层和壁层腹膜。由于临床表现不具特异性，PPM的诊断和治疗常常延迟，且预后较差。本研究调查了影响PPM患者预后和生存的人口统计学、临床和病理因素。
从监测、流行病学和最终结果（SEER）数据库（1975 - 2016年）中提取了1998例PPM患者的人口统计学和临床数据。采用卡方检验、配对检验和多变量分析对数据进行分析。
大多数PPM患者为男性（56.2%，P < 0.005）和白种人（90.4%，P < 0.005），诊断时的平均年龄为69±13岁。在大多数病例中，分级、组织学和肿瘤大小信息被归类为“未知”，但在可获得的情况下，低分化肿瘤（8.7%）、未另行特指的恶性间皮瘤（63.4%）和肿瘤大小>4 cm（8%）最为常见，P < 0.005。50.6%的患者接受了化疗，其次是手术切除（29.2%）和放疗（1.5%），P < 0.001。PPM队列的五年总生存率为20.3%（±1.1），而单独接受手术、放疗或化疗的患者的五年总生存率分别为43.5%（±5.9）、25.9%（±8.4）和18.7%（±1.6）。低分化（OR = 4.2，CI = 3.3 - 4.9）、肿瘤大小>4 cm（OR = 3.9，CI = 3.2 - 4.5）、白种人（OR = 2.9，CI = 2.6 - 4.4）和远处SEER分期（OR = 2.5，CI = 1.1 - 3.2）均与死亡率增加相关（P < 0.001）。
PPM是一种极其罕见且侵袭性强的腹膜肿瘤，诊断时可能难以识别。放疗在这种疾病的治疗中作用可能有限，手术和化疗是主要选择。所有PPM患者都应纳入全国性登记系统，以增进我们对其发病机制的了解并确定影响生存的因素。
