Prognostic factors influencing survival in 35 patients with malignant peritoneal mesothelioma

Abstract Background: Malignant peritoneal mesothelioma (MPM) is a rare disease characterized by atypical symptoms, difficult diagnosis, variable course and poor prognosis, and it develops mainly in the elderly. The authors aimed to identify the clinical-pathological characteristics, prognosis, and prognostic factors in the elderly MPM patients.Methods: From the National Cancer Institute Surveillance Epidemiology End Results (SEER) database, 1492 patients with MPM from 1975 to 2016 were selected and divided into the elderly group (≥65) and the adult group (<65). We compared the clinical-pathological characteristics and treatment methods of elderly group (N=665) and adult group (N=827). At the same time, we analyzed specific selected clinical-pathological parameters and prognostic factors for the elderly MPM patients.Results: Compared with the adult group, the elderly group had a higher percentage of male patients (P = 0.017), white patients (P = 0.043), a lower proportion of insured patients (P < 0.001), married patients (P < 0.001), patients with peritoneal tumors (P = 0.006), patients who underwent surgery (P < 0.001), and chemotherapy (P < 0.001). There was a significant difference in the differentiation grade between the two groups (P = 0.003). The elderly patients had a shorter median survival time compared with the adult patients (6 months vs 19 months). Uninsured (hazard ratio (HR): 5.187, P = 0.005), sarcomatoid type (HR: 3.913, P <0.001), poorly differentiated (HR: 3.900, P < 0.001), distant metastasis (HR: 1.735, P = 0.001), no cancer-directed surgery (HR: 1.733, P < 0.001), and no chemotherapy (HR: 1.532, P < 0.001) were independently associated with poorer prognosis of elderly MPM patients.Conclusion: Compared with the adult patients, elderly MPM patients had higher male ratio, poor differentiation and relatively conservative treatment. The cancer-specific survival (CSS) rate of elderly MPM patients was significantly lower than that of adult patients. Insurance status, histology type, differentiation grade, stage, surgery status, and chemotherapy status were all independent prognostic factors for elderly MPM patients.

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Prognostic Significance of Blood, Serum, and Ascites Parameters in Patients with Malignant Peritoneal Mesothelioma or Peritoneal Carcinomatosis

Gastroenterology Research and Practice ◽

10.1155/2018/2619526 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8

Author(s):

Shan-shan Su ◽

Guo-qi Zheng ◽

Wen-jie Yin ◽

Yu-fei Liang ◽

Ying-ying Liu ◽

...

Keyword(s):

Prognostic Factors ◽

Blood Serum ◽

Peritoneal Carcinomatosis ◽

Prognostic Significance ◽

Peritoneal Mesothelioma ◽

Control Group ◽

Malignant Peritoneal Mesothelioma ◽

Glucose Levels ◽

Peritoneal Effusion ◽

Univariate Analyses

To determine effects of the biochemical and cytological properties of blood, serum, and ascites on survival of patients with malignant peritoneal effusion (MPeE), including malignant peritoneal mesothelioma (MPeM) and peritoneal carcinomatosis (PC), we conducted a retrospective study of patients with MPeE and healthy controls. Potential prognostic factors were identified as follows: age, sex, blood neutrophil-to-lymphocyte ratio (NLR), serum parameters, ascites parameters, serum-ascites albumin gradient, and the ascites-serum LDH ratio. Compared to those of the control group, serum albumin levels were significantly lower, and the NLR and serum LDH levels were significantly higher in the MPeE group. Overall survival (OS) was longer in patients with MPeM compared to that in patients with PC. Compared with patients in the MPeM, patients with PC had higher NLRs, ascites glucose levels, serum-ascites albumin gradients, and serum LDH levels. In contrast, their ascites albumin levels and ascites-serum LDH ratios were lower. Univariate analyses indicated that the NLR, serum LDH levels, ascites LDH levels, ascites coenocyte levels, and the ascites coenocyte-to-monocyte ratios affected the OS. Multivariate analyses identified only serum and ascites LDH levels as independent prognostic factors.

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