Pericardial Mesothelioma: Diagnostic and Therapeutic Management, a Population-Based Study in Italy
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Pericardial mesothelioma (PM) is an extremely rare cancer with a poor prognosis and no consensus on diagnostic and therapeutic management. We conducted a registry-based study on PM cases in Italy diagnosed between 1993 and 2021. METHODS: Based on data from the Italian National Mesothelioma Registry (ReNaM), we performed a descriptive analysis of PM cases including clinical presentation, diagnostic work-up, asbestos exposure, and therapeutic management. Overall survival was calculated. Hazard ratios (HRs) and 95% confidence intervals (CI) for selected variables were estimated with univariate and multivariate Cox models. RESULTS: We identified 72 cases (46 men and 26 women). Median age was 66 years (range 22-89). The most frequent histological subtypes were epithelioid and unspecified mesothelioma. Almost two-thirds of cases had been exposed to asbestos. The most common clinical presentation was pericardial effusion. Overall median survival was 2.8 months (95% CI 1.2-6.6) and older age at diagnosis was a negative prognostic factor. Clinical and treatment data were available for 47 patients (65%). Approximately one out of two patients underwent surgery (palliative, in one-third of cases). Adjuvant therapy was administered to seven patients (15%). In cases with treatment information, sarcomatoid subtype (HR 2.74, 95% CI: 1.06-7.06) was a negative prognostic factor; adjuvant therapy was associated with better survival (HR 0.38, 95% CI 0.14-1.02), but confounding by indication cannot be excluded. CONCLUSIONS: We confirmed the very poor prognosis of PM. An international network collecting PM cases with treatment information is needed to improve patient quality of life and survival.
Source: Cancers
Authors: Simona Stella, Dario Consonni, Giovanni Luca Ceresoli, Barbara Dallari, Riccardo Perduri, Cinzia Storchi, Enrica Migliore, Manuela Gangemi, Carlo Genova, Lucia Benfatto, Vera Comiati, Valentina Zabeo, Sara Piro, Lucia Giovannetti, Iolanda Grappasonni, Cristiana Pascucci, Francesca Larese Filon, Flavia D’Agostin, Luigi Vimercati, Ilaria Cozzi, Franco Calista, Giuseppe Cascone, Italo Francesco Angelillo, Alessandra Binazzi, Alessandro Marinaccio, Carolina Mensi
Institutions: Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Humanitas Gavazzeni, Azienda Sanitaria Unità Locale di Reggio Emilia, Azienda Ospedaliera Citta' della Salute e della Scienza di Torino, University of Turin, Ospedale Policlinico San Martino, University of Genoa, Università di Camerino, University of Trieste, University of Bari Aldo Moro, ASL Roma, Regione Molise, University of Campania "Luigi Vanvitelli", Istituto Nazionale per l'Assicurazione Contro gli Infortuni sul Lavoro
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,499
OpenAlex ID: W4416946116