title: P16 loss and mitotic activity predict poor survival in patients with peritoneal malignant mesothelioma.
abstract: 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.
authors.affiliation: Department of Pathology, Columbia University Medical Center, and the Columbia University Mesothelioma Center, New York, New York 10032, USA. ab748@columbia.edu
authors.forename: Alain C
authors.initials: AC
authors.lastname: Borczuk
authors.forename: Robert N
authors.initials: RN
authors.lastname: Taub
authors.forename: Mary
authors.initials: M
authors.lastname: Hesdorffer
authors.forename: Hanina
authors.initials: H
authors.lastname: Hibshoosh
authors.forename: John A
authors.initials: JA
authors.lastname: Chabot
authors.forename: Mary L
authors.initials: ML
authors.lastname: Keohan
authors.forename: Ritchie
authors.initials: R
authors.lastname: Alsberry
authors.forename: Diane
authors.initials: D
authors.lastname: Alexis
authors.forename: Charles A
authors.initials: CA
authors.lastname: Powell
mesh_terms: 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*
chemical_list: D025803:Tumor Suppressor Protein p14ARF