ArticleThe clinical respiratory journal2025
Distant Metastatic Pattern and Its Prognostic Significance in Malignant Pleural Mesothelioma: A Population-Based Study Based on a Machine Learning Model.
Article in The clinical respiratory journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Distant Metastatic Pattern and Its Prognostic Significance in Malignant Pleural Mesothelioma: A Population-Based Study Based on a Machine Learning Model.The clinical respiratory journal · 2025Article
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8 authors.
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Abstract
backgroundMalignant pleural mesothelioma (MPM) is an insidious and aggressive tumor, often hindering timely clinical interventions. Despite its clinical relevance, epidemiological research focusing on MPM metastases remains limited.
methodsWe conducted a retrospective review of MPM cases with site-specific metastasis records from the Surveillance, Epidemiology, and End Results (SEER) between 2010 and 2019. Propensity Score Matching was employed to minimize bias between distant metastasis and non-distant metastasis groups. A prognostic model for predicting overall survival was established using clinical variables derived from Lasso regression. Variable importance for survival outcomes was estimated using the Random Survival Forests algorithm. The performance of the nomogram was evaluated using the receiver operating characteristic (ROC) curves and calibration plots.
resultsThe presence of distant metastasis significantly reduced median overall survival from 10.5 to 7 months, with further detriment observed in cases with sarcomatoid histology and without chemotherapy intervention. Multivariable analysis identified sarcomatoid subtype, T4 stage, N1+ nodal involvement, and bilateral disease as significant predictors of increased metastatic potential. Histology, surgery, and metastasis status emerged as the top three clinical variables influencing survival. The nomogram demonstrated strong discrimination and calibration for predicting the 1-year and 3-year overall survival in both training and validation cohorts. The contralateral lung was the most frequent site of distant metastasis, with lymph node metastasis presenting a significantly better prognosis than that observed in patients with metastases to other organs.
conclusionsThe large population-based analysis provides a comprehensive characterization of site-specific metastases in MPM. The identified risk factors can help stratify patients at higher risk for metastatic progression and support early, targeted clinical decision-making.
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