Adverse Prognostic Impact of Transitional and Pleomorphic Patterns in Pleural Nonepithelioid Mesothelioma: Insights From Comprehensive Analysis and Reticulin Stain.
Context.--Mesothelioma subtyping into epithelioid and nonepithelioid categories plays a crucial role in prognosis and treatment selection, with emerging recognition of the impact of various histologic patterns. Objective.--To investigate the prognostic implications of transitional and pleomorphic pa...
| Publicado en: | Archives of Pathology & Laboratory Medicine Vol. 149; no. 4; pp. 347 - 354 |
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| Autores principales: | , , , , , , , , , , , , , , , , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
College of American Pathologists
Apr2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=184219852&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 184219852 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00039985 1FS jtl: Archives of Pathology & Laboratory Medicine issn: 00039985 maglogo: N pubinfo: dt: Apr2025 vid: 149 iid: 4 pid: 2550 pub: College of American Pathologists place: Northfield, Illinois artinfo: ui: 184219852 184219852 184219852 10.5858/arpa.2023-0523-OA 184219852 ppf: 347 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Adverse Prognostic Impact of Transitional and Pleomorphic Patterns in Pleural Nonepithelioid Mesothelioma: Insights From Comprehensive Analysis and Reticulin Stain. aug: au: Fortarezza, Francesco Pezzuto, Federica Maniglio, Sonia Marzullo, Andrea d'Amati, Antonio Cavone, Domenica Romano, Daniele Egidio Pentimone, Floriana De Palma, Angela Marulli, Giuseppe Lettini, Teresa Caporusso, Concetta Barbarino, Marcella Salzillo, Cecilia Quaranta, Andrea Calabrese, Fiorella Serio, Gabriella Vimercati, Luigi affil: Pathology Unit, University Hospital of Padova, Padova, Italy sug: subj: Mesothelioma, Malignant Prognosis Histology Chemotherapy, Cancer Pleural Neoplasms Diagnosis Treatment Outcomes Evaluation Survival Rate Human Male Female Adult Retrospective Design Record Review Cox Proportional Hazards Model Regression Kaplan-Meier Estimator Age Factors Proteins Analysis Staining and Labeling Mesothelioma, Malignant Diagnosis Multivariate Analysis Adult: 19-44 years Male Female ab: Context.--Mesothelioma subtyping into epithelioid and nonepithelioid categories plays a crucial role in prognosis and treatment selection, with emerging recognition of the impact of various histologic patterns. Objective.--To investigate the prognostic implications of transitional and pleomorphic patterns in sarcomatoid mesothelioma. Design.--A total of 132 mesothelioma cases (87 biphasic, 45 sarcomatoid) were analyzed. Histologic slides were assessed, treatment data collected, and cases categorized into predominant epithelioid or sarcomatoid patterns. The sarcomatoid mesotheliomas were classified into usual, pleomorphic, and transitional patterns, with reticulin staining for the latter. Statistical analysis included Cox regression and Kaplan-Meier methods. Results.--Younger age (P = .02) and receiving therapy (P < .001) correlated with improved survival for both histotypes. Advanced stage was associated with shorter survival in sarcomatoid cases (P = .02). Predominant epithelioid pattern in biphasic cases led to longer survival (P < .001). Transitional and pleomorphic patterns were indicative of worse prognosis, with significantly lower survival in cases with both patterns than in cases with the usual sarcomatoid pattern (P = .046). Multivariate analysis identified independent survival factors, including predominant epithelioid component in biphasic mesothelioma (P = .001) and chemotherapy (P < .001). Conclusions.--Histologic subtyping in mesothelioma plays a pivotal role in prognosis. Transitional and pleomorphic patterns, even in low percentages, indicate poorer outcomes. This study highlights the need for standardized diagnostic support and suggests the potential utility of histochemical staining in identifying more aggressive morphologic aspects. Recognizing the signifi- cance of these patterns can guide treatment decisions and patient care strategies. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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