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Erschienen in:
10.08.2024 | Thoracic Oncology
Peritoneal Dissemination in Patients with Recurrence After Post-pleurectomy/decortication for Pleural Mesothelioma
verfasst von: Akifumi Nakamura, MD, PhD, Masaki Hashimoto, MD, PhD, Ayumi Kuroda, MD, PhD, Kyoshiro Takegahara, MD, PhD, Akihiro Fukuda, MD, Seiji Matsumoto, MD, PhD, Nobuyuki Kondo, MD, PhD, Toshiyuki Minami, MD, PhD, Kazuhiro Kitajima, MD, PhD, Kozo Kuribayashi, MD, PhD, Takashi Kijima, MD, PhD, Soichiro Funaki, MD, PhD, Seiki Hasegawa, MD, PhD
Erschienen in: Annals of Surgical Oncology | Ausgabe 12/2024
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Background
In clinical practice, peritoneal dissemination after curative-intent surgery for pleural mesothelioma occasionally recurs. This study investigated the risk factors and prognosis associated with post-pleurectomy/decortication peritoneal dissemination in pleural mesothelioma, which are rarely reported.
Methods
This retrospective review included 160 patients who experienced recurrence after pleurectomy/decortication for pleural mesothelioma between January 2011 and December 2021. Patients with recurrence were classified according to the initial recurrence pattern. The P group experienced recurrence with peritoneal dissemination, and the non-P group experienced recurrence without peritoneal dissemination. The analysis determined the risk factors for peritoneal dissemination using multivariable logistic regression analysis. Survival was analyzed using the Kaplan–Meier method and the log-rank test.
Results
Of the 160 patients, 20 (12.5%) exhibited peritoneal dissemination and were assigned to the P group, whereas 140 (87.5%) had recurrence without peritoneal dissemination and were assigned to the non-P group. Multivariable logistic regression analysis showed that diaphragm reconstruction (odds ratio [OR], 2.8; 95% confidence interval [CI], 1.0–8.0; p = 0.048) and female sex (OR, 3.7; 95% CI 1.26–10.8; p = 0.017) were associated with the P group. Post-recurrence survival was worse in the P group than in the non-P group (1-year post-recurrence survival: 22.2% vs. 65.3%; median: 6.7 months vs. 19.4 months; p = 0.0013).
Conclusions
Peritoneal dissemination occurred in approximately one of every eight patients with recurrence after pleurectomy/decortication for pleural mesothelioma, and the incidence was significantly higher among females and patients undergoing diaphragm reconstruction. Moreover, postoperative recurrence of peritoneal dissemination was associated with a poor prognosis.
