Evidence map›Paper›PMID 33060816›Full record

ArticleModern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc2021

Malignant peritoneal mesothelioma: prognostic significance of clinical and pathologic parameters and validation of a nuclear-grading system in a multi-institutional series of 225 cases.

David B Chapel, Jefree J Schulte, Gudrun Absenger, Richard Attanoos, Luka Brcic, Kelly J Butnor, Lucian Chirieac, Andrew Churg, Françoise Galateau-Sallé, Kenzo Hiroshima and 10 more

Open access · bronzeAbstract readMulticenter StudyValidation Study
PubMed Publisher
In one paragraph

Article in Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed
2.4field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 35 citations in OpenAlex.

  1. Article
  2. Article
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  4. Review
  5. Inactivation ofLife (Basel, Switzerland) · 2026
    Article
  6. Article
  7. An Evaluation Into the Robustness of Grading of Pleural Mesothelioma Outside of Specialist Centres.APMIS : acta pathologica, microbiologica, et immunologica Scandinavica · 2025
    Article
  8. Article
  9. Article
  10. Article
  11. Review
  12. Article
  13. Review
  14. Article
  15. Review
  16. Advances in the management of peritoneal malignancies.Nature reviews. Clinical oncology · 2022
    Review
  17. Article
  18. Observational
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors at 12 institutions in 6 countries.

David B ChapelDepartment of Pathology, University of Chicago, Chicago, IL, USA. dchapel@bwh.harvard.edu.ORCID http://orcid.org/0000-0002-9733-5442
Jefree J SchulteDepartment of Pathology, University of Chicago, Chicago, IL, USA.
Gudrun AbsengerDivision of Oncology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria.
Richard AttanoosDepartment of Cellular Pathology, University Hospital of Wales and School of Medicine, Cardiff University, Cardiff, Wales, UK.
Luka BrcicDiagnostic and Research Institute of Pathology, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010, Graz, Austria.ORCID http://orcid.org/0000-0002-9098-8416
Kelly J ButnorDepartment of Pathology, University of Vermont Medical Center, Burlington, VT, USA.
Lucian ChirieacDepartment of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Andrew ChurgDepartment of Pathology, Vancouver General Hospital and University of British Columbia, Vancouver, British Columbia, Canada.
Françoise Galateau-SalléCentre National Référent MESOPATH, Centre Léon Bérard, Lyon, France.
Kenzo HiroshimaDepartment of Biochemistry and Genetics, Chiba University Graduate School of Medicine, Chiba, Japan.ORCID http://orcid.org/0000-0002-0865-0820
Yin P HungDepartment of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.ORCID http://orcid.org/0000-0002-8568-1591
Hedy KindlerDepartment of Medicine, University of Chicago, Chicago, IL, USA.
Thomas KrauszDepartment of Pathology, University of Chicago, Chicago, IL, USA.
Alberto MarchevskyDepartment of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Mari Mino-KenudsonDepartment of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.ORCID http://orcid.org/0000-0002-9092-2265
Jeffrey MuellerDepartment of Pathology, University of Chicago, Chicago, IL, USA.
Kazuki NabeshimaDepartment of Pathology, Fukuoka University School of Medicine and Hospital, Jonan-ku, Fukuoka, Japan.
Kirin TuragaDepartment of Surgery, University of Chicago, Chicago, IL, USA.
Ann E WaltsDepartment of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Aliya N HusainDepartment of Pathology, University of Chicago, Chicago, IL, USA.
University of Chicago · USBrigham and Women's Hospital · USCedars-Sinai Medical Center · USHarvard University · USMedical University of Graz · ATCentre Léon Bérard · FRChiba University · JPFukuoka University Hospital · JPUniversity Hospital of Wales · GBUniversity of British Columbia · CAUniversity of Vermont Medical Center · USUniversity of Wisconsin–Madison · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Malignant peritoneal mesothelioma historically carried a grim prognosis, but outcomes have improved substantially in recent decades. The prognostic significance of clinical, morphologic, and immunophenotypic features remains ill-defined. This multi-institutional cohort comprises 225 malignant peritoneal mesotheliomas, which were assessed for 21 clinical, morphologic, and immunohistochemical parameters. For epithelioid mesotheliomas, combining nuclear pleomorphism and mitotic index yielded a composite nuclear grade, using a previously standardized grading system. Correlation of clinical, morphologic, and immunohistochemical parameters with overall and disease-free survival was examined by univariate and multivariate analyses. On univariate analysis, longer overall survival was significantly associated with diagnosis after 2000 (P = 0.0001), age <60 years (P = 0.0001), ECOG performance status 0 or 1 (P = 0.01), absence of radiographic lymph-node metastasis (P = 0.04), cytoreduction surgery (P < 0.0001), hyperthermic intraperitoneal chemotherapy (P = 0.0001), peritoneal carcinomatosis index <27 (P = 0.01), absence of necrosis (P = 0.007), and epithelioid histotype (P < 0.0001). Among epithelioid malignant mesotheliomas only, longer overall survival was further associated with female sex (P = 0.03), tubulopapillary architecture (P = 0.005), low nuclear pleomorphism (P < 0.0001), low mitotic index (P = 0.0007), and low composite nuclear grade (P < 0.0001). On multivariate analyses, the low composite nuclear grade was independently associated with longer overall and disease-free survival (P < 0.0001). Our data further clarify the interactions of clinical and pathologic features in peritoneal mesothelioma prognosis and validate the prognostic significance of a standardized nuclear-grading system in epithelioid malignant mesothelioma of the peritoneum.

Indexed as

AdolescentAdultAgedAged, 80 and overBiomarkers, TumorCell NucleusDisease-Free SurvivalFemaleHumansMaleMesothelioma, MalignantMiddle AgedMitotic IndexNeoplasm GradingPeritoneal NeoplasmsPrognosisBiomarkers, Tumor

Identifiers

PMID33060816
OpenAlexW3093000805

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.