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Generation and Expansion of Primary, Malignant Pleural Mesothelioma Tumor Lines
Published on: April 21, 2022
Incidence, Survival Analysis and Future Perspective of Primary Peritoneal Mesothelioma (PPM): A Population-Based
Asad Ullah1, Abdul Waheed2, Jaffar Khan3
1Georgia Cancer Center, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA.
Background:
Primary peritoneal mesothelioma (PPM) is a rare and aggressive tumor arising from the visceral and parietal peritoneum. The diagnosis and treatment of PPM are often delayed because of non-specific clinical presentation, and the prognosis is worse. The current study investigated the demographic, clinical, and pathological factors affecting patient prognosis and survival in PPM.
Methods:
Demographic and clinical data of 1998 patients with PPM were extracted from the Surveillance Epidemiology and End Results (SEER) database (1975-2016). The chi-square test, paired t-test, and multivariate analysis were used to analyze the data.
Results:
The majority of PPM patients were male (56.2%, p < 0.005) and Caucasian (90.4%, p < 0.005, with a mean age of diagnosis was 69 ± 13 years. The grading, histological, and tumor size information were classified as "Unknown" in most of the cases, but when available, poorly differentiated tumors (8.7%), malignant mesothelioma, not otherwise specified (63.4%) and tumors > 4 cm in size (8%), respectively, were most common, p < 0.005. Chemotherapy was administered to 50.6% of patients, followed by resection (29.2%) and radiation (1.5%), p < 0.001. The cohort of PPM had a five-year overall survival of 20.3% (±1.1), compared to 43.5% (±5.9), 25.9% (± 8.4), and 18.7% (±1.6) for those with surgery, radiation, or chemotherapy alone, respectively. Poor differentiation (OR = 4.2, CI = 3.3-4.9), tumor size > 4 cm (OR = 3.9, CI = 3.2-4.5), Caucasian race (OR = 2.9, CI = 2.6-4.4), and distant SEER stage (OR = 2.5, CI = 1.1-3.2) were all linked with increased mortality (p < 0.001).
Conclusion:
An extremely rare and aggressive peritoneal tumor, PPM may be difficult to identify at the time of diagnosis. Radiation therapy likely to have a limited function in the treatment of this condition, with surgery and chemotherapy being the primary choices. All PPM patients should be enrolled in a nationwide registry to improve our understanding of the pathogenesis and identify factors affecting survival.
Insights
Primary peritoneal mesothelioma (PPM) is a rare cancer. Poor differentiation, larger tumors, Caucasian race, and advanced stage significantly increase mortality risk in PPM patients.
Area of Science:
- Oncology
- Surgical Pathology
Background:
- Primary peritoneal mesothelioma (PPM) is a rare, aggressive malignancy of the peritoneum.
- Delayed diagnosis due to non-specific symptoms contributes to poorer prognoses.
Purpose of the Study:
- To investigate demographic, clinical, and pathological factors influencing prognosis and survival in primary peritoneal mesothelioma.
- To analyze treatment modalities and their impact on patient outcomes.
Main Methods:
- Retrospective analysis of 1998 primary peritoneal mesothelioma patients from the SEER database (1975-2016).
- Statistical analysis including chi-square test, paired t-test, and multivariate analysis.
Main Results:
- The majority of patients were male (56.2%) and Caucasian (90.4%), with a mean age at diagnosis of 69 years.
- Poorly differentiated tumors, sizes > 4 cm, Caucasian race, and distant SEER stage were associated with increased mortality.
- Five-year overall survival was 20.3%; surgery (43.5%) and chemotherapy (18.7%) showed varied survival impacts.
Conclusions:
- Primary peritoneal mesothelioma is challenging to diagnose and aggressive.
- Surgery and chemotherapy are primary treatment options; radiation therapy appears to have limited efficacy.
- Establishing a nationwide registry is crucial for understanding PPM pathogenesis and survival factors.
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