Risk factors and prognosis of malignant peritoneal mesothelioma with paraneoplastic syndrome

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 factor...

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Main Authors: Xin-Li Liang, Yan-Dong Su, Xin-Bao Li, Yu-Bin Fu, Ru Ma, Rui Yang, He-Liang Wu, Yan Li
Format: Article
Language:English
Published: BMC 2024-01-01
Series:World Journal of Surgical Oncology
Subjects:
Online Access:https://doi.org/10.1186/s12957-024-03312-w
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author Xin-Li Liang
Yan-Dong Su
Xin-Bao Li
Yu-Bin Fu
Ru Ma
Rui Yang
He-Liang Wu
Yan Li
author_facet Xin-Li Liang
Yan-Dong Su
Xin-Bao Li
Yu-Bin Fu
Ru Ma
Rui Yang
He-Liang Wu
Yan Li
author_sort Xin-Li Liang
collection DOAJ
description 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.
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spelling doaj.art-09676f305c7b4138b9c9d2edef04b02a2024-03-05T16:31:46ZengBMCWorld Journal of Surgical Oncology1477-78192024-01-012211910.1186/s12957-024-03312-wRisk factors and prognosis of malignant peritoneal mesothelioma with paraneoplastic syndromeXin-Li Liang0Yan-Dong Su1Xin-Bao Li2Yu-Bin Fu3Ru Ma4Rui Yang5He-Liang Wu6Yan Li7Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Haidian DistrictDepartment of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Haidian DistrictDepartment of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Haidian DistrictDepartment of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Haidian DistrictDepartment of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Haidian DistrictDepartment of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Haidian DistrictDepartment of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Peking University Ninth School of Clinical MedicineDepartment of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Haidian DistrictAbstract 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.https://doi.org/10.1186/s12957-024-03312-wMalignant peritoneal mesotheliomaParaneoplastic syndromeThrombocytosisNeoplastic feverPrognosis
spellingShingle Xin-Li Liang
Yan-Dong Su
Xin-Bao Li
Yu-Bin Fu
Ru Ma
Rui Yang
He-Liang Wu
Yan Li
Risk factors and prognosis of malignant peritoneal mesothelioma with paraneoplastic syndrome
World Journal of Surgical Oncology
Malignant peritoneal mesothelioma
Paraneoplastic syndrome
Thrombocytosis
Neoplastic fever
Prognosis
title Risk factors and prognosis of malignant peritoneal mesothelioma with paraneoplastic syndrome
title_full Risk factors and prognosis of malignant peritoneal mesothelioma with paraneoplastic syndrome
title_fullStr Risk factors and prognosis of malignant peritoneal mesothelioma with paraneoplastic syndrome
title_full_unstemmed Risk factors and prognosis of malignant peritoneal mesothelioma with paraneoplastic syndrome
title_short Risk factors and prognosis of malignant peritoneal mesothelioma with paraneoplastic syndrome
title_sort risk factors and prognosis of malignant peritoneal mesothelioma with paraneoplastic syndrome
topic Malignant peritoneal mesothelioma
Paraneoplastic syndrome
Thrombocytosis
Neoplastic fever
Prognosis
url https://doi.org/10.1186/s12957-024-03312-w
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