title: Effects of sex hormones on survival of peritoneal mesothelioma.
abstract: BACKGROUND
  Previous studies have suggested the presence of steroid receptors as a favourable prognostic factor in peritoneal mesothelioma (PM). This study aims to investigate possible hormonal effects on survival of PM.
  
  
  METHODS
  This is a retrospective study of prospectively collected data of 52 consecutive patients with PM who underwent cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) by the same surgical team at St George Hospital in Sydney, Australia, between April 1996 and April 2013. Females were arbitrarily divided into assumed premenopausal (< 51 years old; n = 15) and assumed postmenopausal (≥ 51 years old, n = 9). In each gender group, patients were furthered divided into three age groups (< 40, 40-60, > 60). A significant statistical difference was defined as p < 0.05.
  
  
  RESULTS
  Females with epithelial mesothelioma had a significantly higher survival than males (p = 0.023). They also had a better overall median survival (> 60 months) than males (43 months), although this difference was not statistically significant (p = 0.098). Survival of postmenopausal females became similar to males after excluding benign cystic mesothelioma.
  
  
  CONCLUSIONS
  The better survival in premenopausal females could probably be explained by higher levels of oestradiol and progesterone. Also, our data suggests that higher rates of benign cystic mesothelioma in females was not the key reason for the better survival in female patients, further supporting the hypothesis of hormonal links with survival of PM. Therapeutic effects of sex steroid hormones on PM may be a valuable area to explore.
authors.affiliation: St George Clinical School, University of New South Wales, Sydney, New South Wales, Australia. yeqian.huang@student.unsw.edu.au.
authors.forename: Yeqian
authors.initials: Y
authors.lastname: Huang
authors.affiliation: College of Medicine, Imam Muhammad ibn Saud Islamic University, Riyadh, Saudi Arabia. nayefalhariri@hotmail.com.|Hepatobiliary and Surgical Oncology Unit, Department of Surgery, St George Hospital, University of New South Wales, Level 3 Pitney Building, Gray Street, Kogarah, Sydney, New South Wales, 2217, Australia. nayefalhariri@hotmail.com.
authors.forename: Nayef A
authors.initials: NA
authors.lastname: Alzahrani
authors.affiliation: Department of Medical Oncology, St George Hospital, University of New South Wales, Sydney, New South Wales, Australia. winston.liauw@sesiahs.health.nsw.gov.au.
authors.forename: Winston
authors.initials: W
authors.lastname: Liauw
authors.affiliation: Hepatobiliary and Surgical Oncology Unit, Department of Surgery, St George Hospital, University of New South Wales, Level 3 Pitney Building, Gray Street, Kogarah, Sydney, New South Wales, 2217, Australia. david.morris@unsw.edu.au.
authors.forename: David L
authors.initials: DL
authors.lastname: Morris
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D012739:Gonadal Steroid Hormones / Q000378:metabolism*; D006801:Humans; D006979:Hyperthermia, Induced; D008175:Lung Neoplasms / Q000378:metabolism* / Q000401:mortality* / Q000628:therapy; D008297:Male; D008654:Mesothelioma / Q000378:metabolism* / Q000401:mortality* / Q000628:therapy; D000086002:Mesothelioma, Malignant; D008875:Middle Aged; D060787:Neoplasm Grading; D010534:Peritoneal Neoplasms / Q000378:metabolism* / Q000401:mortality* / Q000628:therapy; D017698:Postmenopause; D017697:Premenopause; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D012739:Gonadal Steroid Hormones