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Co-occurrence of peritoneal mesothelioma and genitourinary cancers: a case series with comparative outcomes
Emma M Bradley1,2, James L Rogers3, Marissa C Kuo1,2
1Division of Surgical Oncology and Endocrine Surgery, Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.
Objectives:
Peritoneal mesothelioma (PM) shares features with genitourinary (GU) malignancies, including histologic appearance, embryologic origin and genetic predispositions. However, data on their co-occurrence are limited. The study presents a case series of PM patients with associated GU malignancies and explores outcomes following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC).
Methods:
A prospectively maintained CRS-HIPEC database from a tertiary referral center (2011-2024) was reviewed. Demographics, tumor characteristics and outcomes were compared between PM patients with and without GU malignancies (including gynecologic and urologic cancers).
Results:
Among 237 CRS-HIPEC patients, 8/17 patients with PM were found to have another GU malignancy (median age 52.8, 62.5 % male). This included renal cell carcinoma, prostate cancer, ovarian tumors and cervical carcinoma. Most GU malignancies were diagnosed before PM (5/8), two were diagnosed post-CRS-HIPEC, and one synchronously. Three patients reported asbestos exposure; two had BAP1 mutations. Compared to those without GU malignancies, affected patients tended to have higher PCI (19.8 vs. 14.3) and poorer 3-year survival (62.5 vs. 100 %).
Conclusions:
GU malignancy is common among PM patients undergoing CRS-HIPEC and could represent a higher-risk subgroup. These findings raise the hypothesis of a potential association between PM and GU malignancy. Shared origins, oncogenesis of similar cell types, environmental exposures or genetic predispositions may contribute and warrant further investigation.
Insights
Genitourinary (GU) malignancies frequently co-occur with peritoneal mesothelioma (PM) in patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC). This association may indicate a higher-risk subgroup requiring further investigation.
Area of Science:
- Oncology
- Surgical Oncology
- Cancer Epidemiology
Background:
- Peritoneal mesothelioma (PM) shares similarities with genitourinary (GU) cancers, including histology, embryologic origin, and genetic factors.
- Limited data exist on the co-occurrence of PM and GU malignancies.
- Understanding this association is crucial for patient management and risk stratification.
Purpose of the Study:
- To investigate the incidence of GU malignancies in patients with PM undergoing CRS-HIPEC.
- To compare outcomes between PM patients with and without co-occurring GU malignancies.
- To explore potential shared etiologies between PM and GU cancers.
Main Methods:
- A retrospective review of a prospectively maintained CRS-HIPEC database (2011-2024) from a tertiary referral center.
- Analysis of demographic and tumor characteristics of 237 CRS-HIPEC patients.
- Comparison of outcomes (including survival) between PM patients with and without GU malignancies.
Main Results:
- Eight of 17 PM patients (47%) had a co-occurring GU malignancy (renal cell carcinoma, prostate, ovarian, cervical).
- GU malignancies were diagnosed before, synchronously with, or after PM.
- Patients with co-occurring GU malignancies showed a trend towards higher Peritoneal Cancer Index (PCI) and poorer 3-year survival (62.5% vs. 100%).
Conclusions:
- Genitourinary malignancy is a common comorbidity in PM patients treated with CRS-HIPEC.
- This subgroup may represent a higher-risk population.
- Potential shared origins, oncogenesis, environmental exposures, or genetic predispositions warrant further investigation.
