{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T04:36:06Z","timestamp":1764563766190,"version":"3.46.0"},"reference-count":34,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T00:00:00Z","timestamp":1762819200000},"content-version":"vor","delay-in-days":314,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004761","name":"Natural Science Foundation of Hainan Province","doi-asserted-by":"publisher","award":["825QN580"],"award-info":[{"award-number":["825QN580"]}],"id":[{"id":"10.13039\/501100004761","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Respiratory J"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Malignant 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective review of MPM cases with site\u2010specific 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\u2010distant 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The presence of distant metastasis significantly reduced median overall survival from 10.5 to 7\u2009months, 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\u2010year and 3\u2010year 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The large population\u2010based analysis provides a comprehensive characterization of site\u2010specific metastases in MPM. The identified risk factors can help stratify patients at higher risk for metastatic progression and support early, targeted clinical decision\u2010making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/crj.70133","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T10:29:14Z","timestamp":1762856954000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Distant Metastatic Pattern and Its Prognostic Significance in Malignant Pleural Mesothelioma: A Population\u2010Based Study Based on a Machine Learning Model"],"prefix":"10.1111","volume":"19","author":[{"given":"Jian","family":"Yu","sequence":"first","affiliation":[{"name":"Department of Health Statistics Naval Medical University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chi","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Health Statistics Naval Medical University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qianwen","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Oncology Hainan Hospital of Chinese People's Liberation Army General Hospital  Sanya Hainan Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cong","family":"Huo","sequence":"additional","affiliation":[{"name":"Department of Respiratory Hainan Hospital of Chinese People's Liberation Army General Hospital  Sanya Hainan Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Binrui","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Respiratory Hainan Hospital of Chinese People's Liberation Army General Hospital  Sanya Hainan Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qing","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Health Statistics Naval Medical University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yibo","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopedics Central war Zone General Hospital  Wuhan Hubei China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3297-0266","authenticated-orcid":false,"given":"Kaidi","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Oncology Hainan Hospital of Chinese People's Liberation Army General Hospital  Sanya Hainan Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,11]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCO.0000000000000697"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra050152"},{"issue":"2","key":"e_1_2_11_4_1","first-page":"162","article-title":"Latency Periods in Asbestos\u2010Related Mesothelioma of the Pleura","volume":"6","author":"Bianchi C.","year":"1997","journal-title":"European Journal of Cancer Prevention"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2016.09.123"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics10080555"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.2176\/nmc.35.172"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.9246-17"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/cup.13927"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2020.05.032"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0b013e3181f1903e"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0145039"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.1203543"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.29049"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwq224"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.22283\/qbs.2017.36.2.85"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2015.01.043"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2018.06.022"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.681961"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semcdb.2015.01.008"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.abd.2020.07.020"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/0300891620941610"},{"issue":"6","key":"e_1_2_11_23_1","first-page":"591","article-title":"Intracranial Metastases From Malignant Pleural Mesothelioma. 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