Incidence, Survival Analysis and Future Perspective of Primary Peritoneal Mesothelioma (PPM): A Population-Based Study from SEER Database

Abstract

Background: Primary peritoneal mesothelioma (PPM) is a rare and aggressive tumor arising from the visceral and parietal peritoneum. The diagnosis and treatment of PPM are often delayed because of non-specific clinical presentation, and the prognosis is worse. The current study investigated the demographic, clinical, and pathological factors affecting patient prognosis and survival in PPM. Methods: Demographic and clinical data of 1998 patients with PPM were extracted from the Surveillance Epidemiology and End Results (SEER) database (1975–2016). The chi-square test, paired t-test, and multivariate analysis were used to analyze the data. Results: The majority of PPM patients were male (56.2%, p < 0.005) and Caucasian (90.4%, p < 0.005, with a mean age of diagnosis was 69 ± 13 years. The grading, histological, and tumor size information were classified as “Unknown” in most of the cases, but when available, poorly differentiated tumors (8.7%), malignant mesothelioma, not otherwise specified (63.4%) and tumors > 4 cm in size (8%), respectively, were most common, p < 0.005. Chemotherapy was administered to 50.6% of patients, followed by resection (29.2%) and radiation (1.5%), p < 0.001. The cohort of PPM had a five-year overall survival of 20.3% (±1.1), compared to 43.5% (±5.9), 25.9% (± 8.4), and 18.7% (±1.6) for those with surgery, radiation, or chemotherapy alone, respectively. Poor differentiation (OR = 4.2, CI = 3.3–4.9), tumor size > 4 cm (OR = 3.9, CI = 3.2–4.5), Caucasian race (OR = 2.9, CI = 2.6–4.4), and distant SEER stage (OR = 2.5, CI = 1.1–3.2) were all linked with increased mortality (p < 0.001). Conclusion: An extremely rare and aggressive peritoneal tumor, PPM may be difficult to identify at the time of diagnosis. Radiation therapy likely to have a limited function in the treatment of this condition, with surgery and chemotherapy being the primary choices. All PPM patients should be enrolled in a nationwide registry to improve our understanding of the pathogenesis and identify factors affecting survival.

Colorectal Cancer Screening Challenges in the Recent Afghan Refugee Population: A Comprehensive Review Article

“…The new influx of Afghan refugees poses an opportunity to address these barriers and better understand the obstacles preventing these populations from participating in long-term screening opportunities, ultimately reducing colorectal cancer-related mortality and overall healthcare costs [26]. This particular group would benefit from developing a culturally unique approach to providing CRC screening services by addressing language barriers and cultural misconceptions [27][28]. Cultural issues [26][27] Hesitancy related to physical interaction with physicians and healthcare workers mainly associated with the colorectal region Societal support [26][27] Lack of understanding of sociocultural understanding of refugee communities by local populations.…”

“…The new influx of Afghan refugees poses an opportunity to address these barriers and better understand the obstacles preventing these populations from participating in long-term screening opportunities, ultimately reducing colorectal cancer-related mortality and overall healthcare costs [ 26 ]. This particular group would benefit from developing a culturally unique approach to providing CRC screening services by addressing language barriers and cultural misconceptions [ 27 - 28 ].…”

Incidental Finding of Peritoneal Mesothelioma in Recurrent Diverticulitis with A Large Sigmoid Diverticulum

“…Currently the gold standard therapy for peritoneal mesothelioma is Cytoreductive Surgery (CRS) with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in selected patients [9]. Patients, who are not candidates for CRS-HIPEC, will benefit from systemic chemotherapy [2]. For patients with unrespectable tumours, the combined treatment using chemotherapy, radiotherapy and immunotherapy can also be suggested [9].…”

“…The peritoneal mesothelioma makes up nearly 7% of cases [1]. Peritoneal mesothelioma is a rare and aggressive tumour arising from the visceral and parietal peritoneum [2] with a poor prognosis (median survival 6-12months) [3]. The clinical presentations are usually non-specific therefore, often leading to delayed diagnosis and treatment [4].…”

Immunotherapy in malignant peritoneal mesothelioma (Review)

“…According to a large study using the Surveillance, Epidemiology, and End Results (SEER) database, overall patients who had MPeM had a five-year survival rate of 20.3%. The impact of different treatment modalities on the 5-year overall survival (OS) rates was reported to be 43.5% for patients who underwent surgery alone, 25.9, and 18.7% for those who had radiation only, or chemotherapy alone, respectively (8). The majority of patients are symptomatic at presentation.…”