Evidence map›Paper›PMID 42640432›Full record

ArticleAnnals of surgical oncology2026

Prognostic Factors in Patients with Peritoneal Mesothelioma Undergoing Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: A Systematic Review and Meta-Analysis.

Jan Philipp Ramspott, Anna Kolmhofer, Ibrahim Büdeyri, Michael Weitzendorfer, Stephan Regenbogen, Lukas Schabl-Cayron, Philipp Schredl, Alexander D Bungert, Klaus Emmanuel, Dino Bekric and 4 more

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Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

14 authors.

Jan Philipp RamspottDepartment of General, Visceral and Transplant Surgery, University Hospital Muenster, Muenster, Germany. janphilipp.ramspott@gmail.com.ORCID http://orcid.org/0000-0001-9248-2294
Anna KolmhoferCancer Research Laboratory of the Department of Internal Medicine III, University Hospital Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria.
Ibrahim BüdeyriDepartment of General, Visceral and Transplant Surgery, University Hospital Muenster, Muenster, Germany.
Michael WeitzendorferDepartment of Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria.
Stephan RegenbogenDepartment for Orthopaedics and Trauma Surgery at Heidelberg University, BG Klinik Ludwigshafen, Ludwigshafen, Germany.
Lukas Schabl-CayronDepartment of Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria.
Philipp SchredlDepartment of Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria.
Alexander D BungertDepartment of General, Visceral and Transplant Surgery, University Hospital Muenster, Muenster, Germany.
Klaus EmmanuelDepartment of Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria.
Dino BekricInstitute of Pathology, Paracelsus Medical University Salzburg, Salzburg, Austria.
Jaroslav PreslDepartment of Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria.
Andreas PascherDepartment of General, Visceral and Transplant Surgery, University Hospital Muenster, Muenster, Germany.
Daniel Neureiter *Institute of Pathology, Paracelsus Medical University Salzburg, Salzburg, Austria.
Tarkan Jäger *Department of Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDiffuse malignant peritoneal mesothelioma (DMPM) is a rare and aggressive disease in which cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) has improved survival. However, recurrence rates remain high, highlighting the need for reliable prognostic factors to guide patient selection. This systematic review and meta-analysis aimed to evaluate prognostic factors in patients with DMPM undergoing CRS and HIPEC. MATERIALS AND

methodsA systematic literature search of PubMed, MEDLINE, Cochrane Library, Embase, Scopus, and Web of Science was performed up to July 2024. Studies reporting prognostic factors associated with overall and/or progression-free survival were included. Data were pooled using random effects models. Heterogeneity was assessed using the I

resultsA total of eleven studies comprising 891 patients were included. Incomplete cytoreduction, elevated peritoneal cancer index, grade 3-5 postoperative morbidity, prior chemotherapy exposure, World Health Organization performance status ≥ 1, biphasic or sarcomatoid histology, and elevated Ki-67 proliferation index were consistently associated with poorer survival outcomes. Evidence for additional prognostic factors was limited. No prognostic molecular biomarkers could be identified.

conclusionsEstablished clinical-pathological, histological, and immunohistochemical parameters remain the most relevant prognostic factors in patients with DMPM undergoing CRS and HIPEC. These findings facilitate more refined patient selection and support the ongoing standardization of HIPEC protocols for this uncommon and aggressive malignancy. However, the current evidence base is limited and should be interpreted with caution. Future research should prioritize the integration of molecular and genetic biomarkers to enhance prognostic stratification and support personalized treatment approaches.

Indexed as

Cytoreductive surgeryHyperthermic intraperitoneal chemotherapyPeritoneal malignanciesPeritoneal mesotheliomaPrognosisRisk factor

Identifiers

PMID42640432

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