背景:本研究旨在评估人口统计学,“临床病理,恶性腹膜间皮瘤(MPeM)的预后特征,以及罕见和异质MDeM群体的治疗选择。
方法:进行回顾性多中心观察性队列研究,以评估MPEM患者。由于研究人群的异质性,该研究在治疗方面将他们分为两个主要组,后续期,和预后特征。第一组包括接受细胞减灭术(CRS)和腹腔热化疗(HIPEC)的患者,第二组包括无法进行根治性手术的转移性疾病患者.从医疗记录中确定了患者的诊断程序和治疗方法。18岁以上的患者被纳入研究,无论是否接触石棉。本研究未包括高分化乳头状和多囊性间皮瘤的组织学类型。
结果:该研究评估了来自五个中心的118名患者。生存时间,预后,并分析两组的治疗反应。研究表明,CRS-HIPEC与较长的总生存期(OS)和无进展生存期(PFS)相关。在该人群的亚组分析中评估了围手术期治疗,并显示具有生存益处。接受化学疗法治疗的患者(转移性和医学上无法手术的患者以及无法实现完全细胞减少的患者)的预后比手术组差。研究表明,由于任何原因不适合接受手术的患者的预期寿命显着降低。
结论:根据有经验的中心的数据,CRS-HIPEC是一种公认有效的治疗方案,成本效益高,和安全,有了更好的操作系统和PFS,以及与文献中相似的低发病率和死亡率。此外,铂-培美曲塞联合治疗仍然是转移性患者的有效和可接受的治疗选择,那些在医学上无法手术的人,以及那些无法实现完全或接近完全的细胞减少的人。
BACKGROUND: This
study aimed to evaluate the demographic,\" clinicopathologic, and prognostic characteristics of malignant peritoneal mesothelioma (MPeM), as well as the treatment options for the rare and heterogeneous MPeM population.
METHODS: A retrospective multi-center observational cohort
study was conducted to evaluate patients with MPeM. Due to the heterogeneity of the
study population, the
study divided them into two main groups in terms of treatments, follow-up periods, and prognostic features. The first group comprised the patients who underwent cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), and the second group included the patients with metastatic disease for whom curative intent surgery was not possible. The patients\' diagnostic procedures and treatments were identified from medical records. Patients older than 18 years old were included in the
study regardless of asbestos exposure. Well-differentiated papillary and multicystic mesothelioma histologic types were not included in the study.
RESULTS: The
study evaluated 118 patients from five centers. Survival times, prognosis, and treatment responses were analyzed in both groups. The study showed that CRS-HIPEC was associated with longer overall survival (OS) and progression-free survival (PFS). Perioperative therapy was evaluated in subgroup analyses of this population and shown to provide survival benefits. The patients treated with chemotherapy (metastatic and medically inoperable patients and those for whom complete cytoreduction was not achievable) had a poorer prognosis than the surgery group. The study showed that life expectancy decreased significantly for the patients not suitable to undergo surgery for any reason.
CONCLUSIONS: According to data from experienced centers, CRS-HIPEC is a treatment option recognized as effective, cost-effective, and safe, with better OS and PFS , as well as low morbidity and mortality rates similar to those in the literature. In addition, the platinum-pemetrexed combination continues to be an effective and acceptable treatment option for metastatic patients, those who are medically inoperable, and those for whom complete or near-complete cytoreduction is not achievable.