Wang Haoyu, Yang Ruiyuan, Liu Dan, Li Weimin
Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Chengdu, 610041, Sichuan, China.
Sci Rep. 2025 Jan 2;15(1):392. doi: 10.1038/s41598-024-84108-6.
Malignant pleural mesothelioma (MPM) is a rare form of thoracic malignancy with a poor prognosis. Pleural effusion (PE) occurs in the majority of patients with MPM; however, its impact on MPM outcomes remains controversial. We searched for eligible patients from the Surveillance, Epidemiology, and End Results (SEER) database, and clinicopathological information and outcomes were collected. Cox proportional hazard regression analyses were utilized to evaluate the association of PE and other factors with overall survival (OS) and cancer-specific survival (CSS) in patients with MPM. A total of 4185 patients were extracted from the SEER database from 2000 to 2021. The median age of the cohort was 73 years, with a predominance of male patients and epithelioid MPM as the main histological subtype. Univariate Cox regression revealed associations between PE, age, sex, marital status, histology, stage, and treatment with both OS and CSS. Besides, multivariate analyses indicated that PE was independently associated with poorer OS and CSS in patients with MPM, regardless of age, sex, histology, stage, and treatment. Subgroup analyses suggested that PE has a remarkable impact on patients undergoing surgery. PE might serve as an independent prognostic factor in patients with MPM, especially in surgery recipients. Consequently, the development of pleural effusion in these patients should receive increased attention. Future studies are needed to validate these findings, particularly concerning the effect of PE in other clinical settings, such as immunotherapy.
恶性胸膜间皮瘤（MPM）是一种罕见的胸部恶性肿瘤，预后较差。大多数MPM患者会出现胸腔积液（PE）；然而，其对MPM预后的影响仍存在争议。我们从监测、流行病学和最终结果（SEER）数据库中搜索符合条件的患者，并收集临床病理信息和预后情况。采用Cox比例风险回归分析来评估PE和其他因素与MPM患者总生存期（OS）和癌症特异性生存期（CSS）的关联。从2000年到2021年，共从SEER数据库中提取了4185例患者。该队列的中位年龄为73岁，男性患者居多，上皮样MPM为主要组织学亚型。单因素Cox回归显示，PE、年龄、性别、婚姻状况、组织学、分期和治疗与OS和CSS均有关联。此外，多因素分析表明，无论年龄、性别、组织学、分期和治疗情况如何，PE与MPM患者较差的OS和CSS独立相关。亚组分析表明，PE对接受手术的患者有显著影响。PE可能是MPM患者的独立预后因素，尤其是在接受手术的患者中。因此，应更加关注这些患者胸腔积液的发生。需要进一步的研究来验证这些发现，特别是关于PE在其他临床环境中的作用，如免疫治疗。
