Analysis of prognostic influencing factors of malignant peritoneal mesothelioma
10.3760/cma.j.cn115355-20240518-00246
- VernacularTitle:恶性腹膜间皮瘤预后影响因素分析
- Author:
Yuting FANG
1
;
Zhichao JIANG
;
Yaru NIU
;
Midan XIANG
;
Wei PEI
;
Guangwen YUAN
;
Yongkun SUN
Author Information
1. 国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院北京协和医学院肿瘤医院内科，北京 100021
- Publication Type:Journal Article
- Keywords:
Mesothelioma;
Peritoneum;
Prognosis;
Drug therapy, combination
- From:
Cancer Research and Clinic
2024;36(12):933-937
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical characteristics and prognostic factors of malignant peritoneal mesothelioma (MPeM).Methods:A retrospective case series study was conducted. Clinical and follow-up data of 73 MPeM patients who received pemetrexed and cisplatin (AP regimen)-based treatment at the Cancer Hospital of the Chinese Academy of Medical Sciences from January 2004 to December 2022 were collected. The primary endpoints were overall survival (OS) and progression-free survival (PFS). Kaplan-Meier method was used to perform the survival analysis; univariate and multivariate analyses were performed to identify the influencing factors of prognosis by log-rank test and Cox proportional hazards model.Results:In 73 MPeM patients, there were 33 males and 40 females, with a median age of 57 years old (range: 20-76 years old). Among them, 41 patients (56.2%) were aged ≥55 years old, 5 patients (6.8%) had a history of asbestos exposure, 45 patients (61.6%) presented with ascites, and 32 patients (43.8%) had distant metastasis, 70 patients (95.9%) were epithelioid subtype, 38 patients (52.1%) underwent surgery, and 3 patients (4.1%) received radiotherapy. The median OS time of all patients was 30 months (95% CI: 25-50 months), and the median PFS time was 8 months (95% CI: 6-14 months). Univariate analysis results showed that the differences in OS and PFS between patients with different ages (<55 years old vs. ≥55 years old: the median OS time not reached vs. 25 months, P < 0.001; the median PFS time 13 months vs. 7 months, P = 0.046) and Eastern Cooperative Oncology Group (ECOG) score (1 point vs. 2 points: the median OS time 37 months vs. 21 months, P < 0.001; the median PFS time 14 months vs. 4 months, P = 0.004) were statistically significant. There were statistically significant differences in OS among patients with different status of surgery (with vs. without: the median OS time 37 months vs. 24 months, P = 0.020), history of asbestos exposure (with vs. without: the median OS time 32 months vs. 18 months, P = 0.002) and distant metastasis (with vs. without: the median OS time 58 months vs. 20 months, P < 0.001). Multivariate analysis results showed that ECOG score of 2 points ( HR = 5.04, 95% CI: 1.29-19.73, P = 0.020) and distant metastasis ( HR = 4.26, 95% CI: 1.77-10.24, P = 0.001) were independent risk factors for OS of patients. Conclusions:Most MPeM patients are female, the epithelioid subtype is predominant, and the overall prognosis is poor. However, patients aged <55 years old, without history of asbestos exposure, with a good general condition, with surgery, or without distant metastasis have relatively good prognosis.
