BACKGROUND: This study evaluates clinical, radiological and histopathological prognostic indicators for survival of patients undergoing cytoreductive surgery and perioperative intraperitoneal chemotherapy for diffuse malignant peritoneal mesothelioma (DMPM). METHODS: Sixty-two consecutive patients with DMPM underwent cytoreduction and perioperative intraperitoneal chemotherapy at the Washington Cancer Institute. Twenty-six clinical, radiological and histopathological parameters were analyzed in univariate and multivariate analyses using overall survival as an endpoint. RESULTS: The overall survival was 79 months (range 1-143 months), with 1-, 3- and 5-year survival rates of 84%, 58% and 50%, respectively. The following 14 prognostic variables were significant for survival in the univariate analysis: gender (P = .045), peritoneal cancer index (P = .038), completeness of cytoreduction score (P = .010), interpretive CT findings of the small bowel and mesentery (P = .001), mesothelioma cell type (P < .001), mesothelioma nuclear size (P < .001), nuclear/cytoplasmic ratio (P < .001), mitotic count (P < .001), atypical mitosis (P < .001), chromatin pattern (P < .001), cellular necrosis (P < .001), perineural invasion (P = .037), stroma pattern (P < .001) and depth of invasion (P = .014). In the multivariate analysis, the only factor that was independently associated with an improved survival after cytoreduction and perioperative intraperitoneal chemotherapy was mesothelioma nuclear size. CONCLUSIONS: Mesothelioma nuclear size was the dominant factor determining overall survival in patients with DMPM. A histopathological staging system based on measurement of the nuclear size was proposed.
BACKGROUND: This study evaluates clinical, radiological and histopathological prognostic indicators for survival of patients undergoing cytoreductive surgery and perioperative intraperitoneal chemotherapy for diffuse malignant peritoneal mesothelioma (DMPM). METHODS: Sixty-two consecutive patients with DMPM underwent cytoreduction and perioperative intraperitoneal chemotherapy at the Washington Cancer Institute. Twenty-six clinical, radiological and histopathological parameters were analyzed in univariate and multivariate analyses using overall survival as an endpoint. RESULTS: The overall survival was 79 months (range 1-143 months), with 1-, 3- and 5-year survival rates of 84%, 58% and 50%, respectively. The following 14 prognostic variables were significant for survival in the univariate analysis: gender (P = .045), peritoneal cancer index (P = .038), completeness of cytoreduction score (P = .010), interpretive CT findings of the small bowel and mesentery (P = .001), mesothelioma cell type (P < .001), mesothelioma nuclear size (P < .001), nuclear/cytoplasmic ratio (P < .001), mitotic count (P < .001), atypical mitosis (P < .001), chromatin pattern (P < .001), cellular necrosis (P < .001), perineural invasion (P = .037), stroma pattern (P < .001) and depth of invasion (P = .014). In the multivariate analysis, the only factor that was independently associated with an improved survival after cytoreduction and perioperative intraperitoneal chemotherapy was mesothelioma nuclear size. CONCLUSIONS:Mesothelioma nuclear size was the dominant factor determining overall survival in patients with DMPM. A histopathological staging system based on measurement of the nuclear size was proposed.
Authors: David B Chapel; Jefree J Schulte; Gudrun Absenger; Richard Attanoos; Luka Brcic; Kelly J Butnor; Lucian Chirieac; Andrew Churg; Françoise Galateau-Sallé; Kenzo Hiroshima; Yin P Hung; Hedy Kindler; Thomas Krausz; Alberto Marchevsky; Mari Mino-Kenudson; Jeffrey Mueller; Kazuki Nabeshima; Kirin Turaga; Ann E Walts; Aliya N Husain Journal: Mod Pathol Date: 2020-10-15 Impact factor: 7.842
Authors: Nicholas P Schaub; Meghna Alimchandani; Martha Quezado; Phil Kalina; John S Eberhardt; Marybeth S Hughes; Tatiana Beresnev; Raffit Hassan; David L Bartlett; Steven K Libutti; James F Pingpank; Richard E Royal; Udai S Kammula; Prakash Pandalai; Giao Q Phan; Alexander Stojadinovic; Udo Rudloff; H Richard Alexander; Itzhak Avital Journal: Ann Surg Oncol Date: 2012-12-12 Impact factor: 5.344
Authors: Jason M Foster; Uppala Radhakrishna; Venkatesh Govindarajan; Joseph H Carreau; Zoran Gatalica; Poonam Sharma; Swapan K Nath; Brian W Loggie Journal: World J Surg Oncol Date: 2010-10-13 Impact factor: 2.754