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Abstract：
BACKGROUND: Malignant peritoneal mesothelioma (MPM) is a rare and highly aggressive tumor. Its clinical manifestations are diverse, and the symptoms are not specific. Some patients will develop paraneoplastic syndrome (PS) during the disease course. This study aims to analyze the risk factors of PS in patients with MPM and their impacts on prognosis.
METHODS: The clinical data of MPM patients who underwent cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS + HIPEC) at our center from June 2015 to May 2023 were retrospectively analyzed. MPM patients were divided into PS group and non-PS group according to the diagnostic criteria. Univariate and multivariate analyses were performed to explore the risk factors of PS in MPM patients, and to analyze the impact of PS on prognosis.
RESULTS: There were 146 MPM patients in this study, including 60 patients (41.1%) with PS and 86 patients (58.9%) without PS. The highest incidence of PS was thrombocytosis (33.6%), followed by neoplastic fever (9.6%). Univariate analysis revealed 8 factors (P < 0.05) with statistically significant differences between the two groups: prior surgical scores, targeted therapy history, Karnofsky performance status score, preoperative carbohydrate antigen (CA) 125 level, vascular tumor embolus, peritoneal cancer index, completeness of cytoreduction (CC) score and intraoperative ascites. Multivariate analysis identified 3 independent factors associated with PS: preoperative CA 125 level, vascular tumor embolus, and CC score. Survival analysis demonstrated that MPM patients with PS had worse prognosis, although PS was not an independent prognostic factor.
CONCLUSIONS: PS is not rare in patients with MPM, and is independently associated with preoperative CA 125 level, vascular tumor embolus and CC score. PS often indicates advanced disease and poor prognosis.
METHODS: The clinical data of MPM patients who underwent cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (CRS + HIPEC) at our center from June 2015 to May 2023 were retrospectively analyzed. MPM patients were divided into PS group and non-PS group according to the diagnostic criteria. Univariate and multivariate analyses were performed to explore the risk factors of PS in MPM patients, and to analyze the impact of PS on prognosis.
RESULTS: There were 146 MPM patients in this study, including 60 patients (41.1%) with PS and 86 patients (58.9%) without PS. The highest incidence of PS was thrombocytosis (33.6%), followed by neoplastic fever (9.6%). Univariate analysis revealed 8 factors (P < 0.05) with statistically significant differences between the two groups: prior surgical scores, targeted therapy history, Karnofsky performance status score, preoperative carbohydrate antigen (CA) 125 level, vascular tumor embolus, peritoneal cancer index, completeness of cytoreduction (CC) score and intraoperative ascites. Multivariate analysis identified 3 independent factors associated with PS: preoperative CA 125 level, vascular tumor embolus, and CC score. Survival analysis demonstrated that MPM patients with PS had worse prognosis, although PS was not an independent prognostic factor.
CONCLUSIONS: PS is not rare in patients with MPM, and is independently associated with preoperative CA 125 level, vascular tumor embolus and CC score. PS often indicates advanced disease and poor prognosis.
摘要：
背景：恶性腹膜间皮瘤（MPM）是一种罕见且高度侵袭性的肿瘤。其临床表现多样,症状并不具体。一些患者在病程中会出现副肿瘤综合征（PS）。本研究旨在分析MPM患者发生PS的危险因素及其对预后的影响。
方法：回顾性分析2015年6月至2023年5月在我中心行细胞减灭术联合腹腔热灌注化疗（CRS+HIPEC）的MPM患者的临床资料。根据诊断标准将MPM患者分为PS组和非PS组。单因素和多因素分析探讨MPM患者发生PS的危险因素,并分析PS对预后的影响。
结果：本研究共有146例MPM患者，其中PS患者60例(41.1%),无PS患者86例(58.9%)。PS发病率最高的是血小板增多症(33.6%),其次是肿瘤热(9.6%)。单因素分析显示8个因素(P<0.05),两组间差异有统计学意义:手术前评分,靶向治疗史,Karnofsky表演状态得分，术前碳水化合物抗原（CA）125水平，血管肿瘤栓子，腹膜癌指数，细胞减灭术（CC）评分和术中腹水的完整性。多因素分析确定了与PS相关的3个独立因素：术前CA125水平，血管肿瘤栓子，CC得分。生存分析显示MPM合并PS患者预后较差,虽然PS不是独立的预后因素。
结论：PS在MPM患者中并不罕见，并且与术前CA125水平独立相关，血管肿瘤栓子和CC评分。PS常提示疾病进展和预后不良。
方法：回顾性分析2015年6月至2023年5月在我中心行细胞减灭术联合腹腔热灌注化疗（CRS+HIPEC）的MPM患者的临床资料。根据诊断标准将MPM患者分为PS组和非PS组。单因素和多因素分析探讨MPM患者发生PS的危险因素,并分析PS对预后的影响。
结果：本研究共有146例MPM患者，其中PS患者60例(41.1%),无PS患者86例(58.9%)。PS发病率最高的是血小板增多症(33.6%),其次是肿瘤热(9.6%)。单因素分析显示8个因素(P<0.05),两组间差异有统计学意义:手术前评分,靶向治疗史,Karnofsky表演状态得分，术前碳水化合物抗原（CA）125水平，血管肿瘤栓子，腹膜癌指数，细胞减灭术（CC）评分和术中腹水的完整性。多因素分析确定了与PS相关的3个独立因素：术前CA125水平，血管肿瘤栓子，CC得分。生存分析显示MPM合并PS患者预后较差,虽然PS不是独立的预后因素。
结论：PS在MPM患者中并不罕见，并且与术前CA125水平独立相关，血管肿瘤栓子和CC评分。PS常提示疾病进展和预后不良。
