P16 loss and mitotic activity predict poor survival in patients with peritoneal malignant mesothelioma.
OBJECTIVE
Peritoneal malignant mesothelioma is an aggressive neoplasm for which intensive therapy improves survival in a subset of patients. We hypothesized that pathologic variables would stratify patients into favorable and unfavorable survival subgroups.


METHODS
Fifty-four patients with peritoneal malignant mesothelioma were evaluated for trimodal therapy from 1995 to 2003. Two pathologists evaluated pathologic variables independently, and p16 status was analyzed by immunohistochemistry.


RESULTS
Patients not receiving trimodal therapy had a significantly increased risk of death [hazard ratio (HR), 9.6; 4.3-21.6; P < 0.0001]. Biphasic histology was also associated with increased risk of death (HR, 8.5; 3.4-21.8; P < 0.0001). In multivariate analysis adjusting for treatment modality and histologic type, high mitotic rate and p16 loss were associated with increased risk of death (HR, 3.074; 1.05-9.0; P < 0.04 and HR, 3.65; 1.3-10.2; P < 0.014, respectively).


CONCLUSIONS
Biphasic histology, increased mitotic rate, and p16 loss were independently associated with poorer survival in peritoneal malignant mesothelioma. Among the trimodal treated patients, increased mitotic rate was associated with increased risk of death.
Borczuk
Alain C
AC
Department of Pathology, Columbia University Medical Center, and the Columbia University Mesothelioma Center, New York, New York 10032, USA. ab748@columbia.edu
Taub
Robert N
RN
Hesdorffer
Mary
M
Hibshoosh
Hanina
H
Chabot
John A
JA
Keohan
Mary L
ML
Alsberry
Ritchie
R
Alexis
Diane
D
Powell
Charles A
CA
D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008654:Mesothelioma / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D008875:Middle Aged; D008938:Mitosis; D015999:Multivariate Analysis; D010534:Peritoneal Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D011379:Prognosis; D016019:Survival Analysis; D016896:Treatment Outcome; D025803:Tumor Suppressor Protein p14ARF / Q000032:analysis*
D025803:Tumor Suppressor Protein p14ARF