Experience with peritoneal mesothelioma at the Milan National Cancer Institute

Table 1 Clinicopathologic variables with prognostic significance according to univariate (log-rank) and multivariate (Cox proportional hazard model) analyses

Variable	Overall survival			Progression-free survival
	Univariate	Multivariate		Univariate	Multivariate
	P value	HR (95% CI)	P value	P value	HR (95% CI)	P value
Sex	0.22			0.27
Age (< 52 yrvs≥52 yr)	0.93			0.49
Performance status (0vs1, 2, or 3)	0.43			0.05	0.29 (0.1-0.8)	0.02
Previous surgical score (0vs≥1)	0.78			0.11
Previous systemic CT	0.59			0.57
PCI (≥28vs< 28)	0.12			0.10
Completeness of cytoreduction (0/1vs2/3)a	0.01	8.6 (2.1-36.2)	0.00	0.08
IPHP drug schedule (CDDP + DXvsCDDP + MMC)	0.36			0.98
Histological subtype (epithelioidvsbiphasic)	0.09			0.07
Mitotic count(< 5vs≥5)	0.01	10.5 (1.9-55.2)	0.01	0.19	3.1 (1.1-8.8)	0.03
Nuclear grade (highvslow)	0.02			0.10

^a0/1, minimal residual disease or residual tumor < 2.5 mm; 2/3, residual tumor ≥ 2.5 mm. CI: Confidence interval; PCI: Peritoneal Cancer Index; IPHP: Intraperitoneal hyperthermic perfusion; CDDP: Cisplatin; DX: Doxorubicin; MMC: Mitomycin C; HPF: High-power field.

Table 2 Immunohistochemical results

Score	No. of patients (n)
	Calretinin	WT-1	pCEA	Ber-Ep4	EGFR	p16	MMP-2	MMP-9
0	0	0	35	35	2	14	0	5
+1	0	5	0	0	1	11	2	9
+2	1	6	0	0	3	6	3	8
+3	6	5	0	0	7	2	7	8
+4	28	19	0	0	22	2	23	5

The immunohistochemistry stains were scored as 0 (negative), +1 (< 25%), +2 (25%-50%), +3 (50%-75%), and +4 (75%-100%). pCEA: Pathologic carcinoembryonic antigen; EGFR: Epidermal growth factor receptor; MMP: Matrix metalloproteinase.

Table 3 Staining characteristics for IAP family members, Smac/DIABLO, apoptotic and proliferation indices in peritoneal mesothelioma

	Positive cases	Median expression
	(n)	(range, %)
Survivin, full length1	26	60 (0-100)
Survivin, specific nuclear form	7	1.5 (0-20)
IAP-21	32	90 (30-100)
IAP-1	32	95 (40-100)
X-IAP	22	50 (0-100)
Smac/DIABLO	11	5 (0-90)
Apoptotic index (CK18-caspase cleavage product)	-	0.45 (0-5.8)
Proliferation index (Ki-67)	-	10 (0-50)

¹Cytoplasmic/nuclear subcellular distribution.