Clinical, Imaging, Pathological and Prognostic Analysis of Primary Malignant Pericardial Mesothelioma in Inland China: A 35-year Review / 中国循环杂志

ABSTRACT

Objectives: To explore the clinical feathers and prognosis of primary malignant pericardial mesothelioma (PPM) reported in inland China. Methods: We searched Chinese data bases and collected medical records of PPM from 1981 to 2015 for patients' clinical, imaging, pathological, diagnostic and therapeutic information to explore the possible impact factors for prognosis. Results: A total of 186 patients were enrolled including 122 (65.6％) male, the mean age was (40.9±14.5) years at the range of (2-79) years. There were 108/166 (65.1％) patients suffered from dyspnea which was the most common symptom, 17 (10.2％) were complicated with cardiac tamponade and 48 (28.9％) complicated with constrictive pericarditis. 65 patients were misdiagnosed and 40 (61.5％) of them were diagnosed for tubercular pericarditis. 94 patients died and 30 (31.9％) of them died during hospitalization. 86 patients were discharged and received the follow-up study at the median of 6 months, 64 (74.4％) of them died. Multivariate Cox regression analysis did not find the meaningful clinical, imaging or pathological parameters to predict patients' mortality. Conclusion: PPM is a rare and highly aggressive pericardial malignant tumor, mainly involving middle-age males. Pathological combining immunohistochemical examinations are helpful for PPM diagnosis. Effective therapy has been lacking and comprehensive individualized therapy may improve the patients' prognosis.