Diffuse mesothelioma of the peritoneum: correlation between histological and clinical parameters and survival in 73 patients

• Published in: Pathology 2014-12, Vol.46 (7), p.604-609
• Main Authors: Liu, Sandy, Staats, Paul, Lee, Michael, Alexander, H. Richard, Burke, Allen P.
• Format: Article
• Language: English
• Subjects: Adenomatoid tumour; Adolescent; Adult; Aged; Aged, 80 and over; Biomarkers, Tumor - analysis; deciduoid; Female; Follow-Up Studies; Humans; Immunohistochemistry - methods; Lung Neoplasms - mortality; Lung Neoplasms - pathology; lymphohistiocytoid; Male; mesothelioma; Mesothelioma - mortality; Mesothelioma - pathology; Mesothelioma, Malignant; Middle Aged; multicystic; Peritoneal Neoplasms - mortality; Peritoneal Neoplasms - pathology; peritoneum; Peritoneum - pathology; Prognosis; Retrospective Studies; Young Adult
• ISSN: 0031-3025; 1465-3931
• DOI: 10.1097/PAT.0000000000000181

There are few studies addressing survival of diffuse peritoneal mesotheliomas (DPM). In this study, survival data were obtained retrospectively from 73 patients treated with intended cytoreductive surgery for DPM, with a mean follow-up of 42 months. Mesotheliomas were classified as well differentiated papillary (WDPM, n=2), multicystic (MCM, n=4), and epithelioid mesotheliomas were subclassified as tubulopapillary (TPM, n=27), solid/deciduoid (S/DM, n=34), and or biphasic mesothelioma (BPM, n=6). Invasion was characterised as absent (grade 0), into stroma (grade 1), into fat (grade 2), and into adjacent structures (grade 3). Peritoneal cancer index (PCI) and completeness of cytoreduction (CCR) were assessed surgically. There were no deaths in the WDPM, MCM, and epithelioid DPM with ≤ grade 1 invasion. There was a stepwise decrease in overall survival from invasive TPM, S/DM, and BPM (p < 0.0001). By univariate analysis, advanced age (p=0.01), incomplete CCR (p < 0.001), PCI (p=0.004), mitotic count (p