Obstetrics and Gynecology Department, Yuyao People's Hospital of Zhejiang Province, Yuyao, 315400, Zhejiang, China.
World J Surg Oncol. 2022 Jun 29;20(1):219. doi: 10.1186/s12957-022-02688-x.
Prognosis in malignant peritoneal mesothelioma (MPM) remains poor, and the associated factors are unclear. Therefore, this study aimed to investigate the prognostic factors of MPM.
A total of 52 female MPM patients treated in 2012-2017 were retrospectively analyzed. Kaplan-Meier survival curves were generated for survival analysis by the log-rank test. The Cox regression model was used for univariate and multivariate analyses.
Univariate analysis showed that median survival time (MST) was longer in the epithelioid type compared with the sarcomatoid type (12 months vs 5 months); cumulative survival rates at 12 months were 45.7% and 0%, respectively (P=0.005). MST was longer in patients with proliferating cell nuclear antigen (Ki67) ≤ 10% compared with those with Ki67 > 10% (15 months vs 11 months). Cumulative survival rates at 12 months were 60.0% and 28.1%, respectively (P=0.036). MSTs in patients administered peritoneal biopsy or adnexectomy + paclitaxel + platinum perfusion, peritoneal biopsy (or adnexectomy) + pemetrexed + platinum perfusion, cytoreductive surgery + paclitaxel + platinum perfusion, and cytoreductive surgery + pemetrexed + platinum perfusion were 6, 11, 12, and 24 months, respectively, with cumulative survival rates at 12 months of 0%, 35.7%, 45.5%, and 73.3%, respectively. Survival time after cytoreductive surgery combined with pemetrexed + platinum was the longest. In multivariate analysis, pathological type, T staging, and therapeutic regimen were independent prognostic factors of MPM (P < 0.05).
Prognosis in MPM is associated with pathological subtype, clinical staging, cytoreductive surgery, and subsequent pemetrexed use. Radical cytoreductive surgery and postoperative use of pemetrexed prolong survival.
恶性腹膜间皮瘤（MPM）的预后仍然较差，其相关因素尚不清楚。因此，本研究旨在探讨 MPM 的预后因素。
回顾性分析 2012-2017 年收治的 52 例女性 MPM 患者。采用对数秩检验生成 Kaplan-Meier 生存曲线进行生存分析。采用单因素和多因素分析 Cox 回归模型。
单因素分析显示，上皮样型的中位生存时间（MST）长于肉瘤样型（12 个月比 5 个月）；12 个月时的累积生存率分别为 45.7%和 0%（P=0.005）。Ki67≤10%的患者的 MST 长于 Ki67＞10%的患者（15 个月比 11 个月）。12 个月时的累积生存率分别为 60.0%和 28.1%（P=0.036）。接受腹膜活检或附件切除术+紫杉醇+铂灌注、腹膜活检（或附件切除术）+培美曲塞+铂灌注、细胞减灭术+紫杉醇+铂灌注和细胞减灭术+培美曲塞+铂灌注的患者 MST 分别为 6、11、12 和 24 个月，12 个月时的累积生存率分别为 0%、35.7%、45.5%和 73.3%。细胞减灭术联合培美曲塞+铂治疗后生存时间最长。多因素分析显示，病理类型、T 分期和治疗方案是 MPM 的独立预后因素（P＜0.05）。
MPM 的预后与病理亚型、临床分期、细胞减灭术以及随后培美曲塞的使用有关。根治性细胞减灭术和术后使用培美曲塞可延长生存时间。
