Analysis of Histologic Parameters Associated with Nuclear Size in Diffuse Malignant Peritoneal Mesothelioma Uniformly Treated by Cytoreductive Surgery and Perioperative Intraperitoneal Chemotherapy

Abstract

Aims: Nuclear size has been identified as a significant prognostic indicator for survival after cytoreductive surgery and perioperative intraperitoneal chemotherapy for diffuse malignant peritoneal mesothelioma (DMPM). The additional histopathologic features associated within the clinical material have not been determined. This current study assessed the correlations between nuclear size and 12 other histopathologic parameters. Methods: A review of the histopathological features of DMPM in 62 patients who underwent uniform management of cytoreductive surgery and perioperative intraperitoneal chemotherapy was performed. Nuclear size was categorized into two groups: ≤ 30 µ.m (n = 35) versus > 30 µ.m (n = 27). The correlations between nuclear size and 12 histopathologic parameters of DMPM were determined by univariate analysis. Results: Patients with nuclear size > 30 µ.m had a less favorable prognosis, as compared to patients with nuclear size ≤ 30 µ.m (p < .001). Nuclear size was statistically correlated with histologic type (p = .012), nuclear/cytoplasmic ratio (p < .001), mitotic count (p = .001), atypical mitosis (p < .001), tumor necrosis (p < .001), chromatin pattern (p < .001) and nucleolar size (p < .001). Conclusions: Histopathologic features present along with nuclear size are histologic type, nuclear/cytoplasmic ratio, mitotic count, atypical mitosis, tumor necrosis, chromatin pattern and nucleolar size in patients undergoing cytoreductive surgery and perioperative intraperitoneal chemotherapy. The identification of these histopathologic features may function as an adjunct to nuclear size in the estimation of prognosis.