Distant Metastatic Pattern and Its Prognostic Significance in Malignant Pleural Mesothelioma: A Population-Based...

Area of Science:

• Oncology
• Epidemiology
• Biostatistics

Background:

• Malignant pleural mesothelioma (MPM) is an aggressive cancer with limited epidemiological data on its metastases.
• Timely clinical interventions are often hindered by the nature of MPM.

Purpose of the Study:

• To characterize site-specific metastases in MPM using a large population-based dataset.
• To identify risk factors for metastatic progression and develop a prognostic model for overall survival.

Main Methods:

• Retrospective review of MPM cases (2010-2019) from the Surveillance, Epidemiology, and End Results (SEER) database.
• Propensity Score Matching to compare distant metastasis groups.
• Lasso regression and Random Survival Forests for prognostic model development and variable importance analysis.

Main Results:

• Distant metastasis reduced median overall survival from 10.5 to 7 months.
• Sarcomatoid histology, T4 stage, N1+ nodal involvement, and bilateral disease predicted increased metastatic potential.
• Contralateral lung was the most frequent metastasis site; lymph node metastasis had a better prognosis than other sites.

Conclusions:

• This study provides a comprehensive characterization of MPM metastases.
• Identified risk factors aid in stratifying patients for early, targeted clinical decision-making.