{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T19:15:34Z","timestamp":1780514134111,"version":"3.54.1"},"reference-count":21,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T00:00:00Z","timestamp":1756166400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: Unlike other thoracic malignancies, seeding malignant cells along surgical tracts is a known complication of invasive diagnostic or therapeutic procedures for pleural mesothelioma (PM). We report the tract dissemination rate and risk factors in 308 consecutive patients treated over 9 years in a single institution who underwent pleurectomy decortication (PD). Methods: Clinical and outcome data were reviewed. Fisher\u2019s exact test, Kaplan\u2013Meier estimators, and log-rank tests were used to identify significant risk factors for surgical tract dissemination and to compare overall survival. Results: There were 233 males (75.6%), 187 right-sided operations (61%), 190 (61.7%) epithelioid histology cases, and the median age was 69 (29\u201384). During the study, malignant cell dissemination in resected surgical tracts was diagnosed in 69 (22.4%) patients. The dissemination rates in epithelioid, biphasic, and sarcomatoid tumors were 24.7%, 20.4%, and 0%, respectively. Disseminated malignant surgical tract was associated with advanced nodal status (p = 0.001), advanced staging by the American Joint Committee on Cancer (AJCC 8th edition, p = 0.03), female sex (0.02), side of surgery (p = 0.03), and the number of video-assisted thoracoscopic surgery (VATS) ports (p = 0.003). In epithelioid mesothelioma, the median survival from diagnosis was 19.7 months in patients with tract seeding versus 36.3 months in patients without seeding (hazard ratio, 1.9; p = 0.001). Conclusions: Procedure tract dissemination occurs in almost every fourth patient with pleural mesothelioma and is associated with shorter overall survival in the epithelioid subtype.<\/jats:p>","DOI":"10.3390\/cancers17172786","type":"journal-article","created":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T14:18:49Z","timestamp":1756217929000},"page":"2786","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Malignant Local Seeding in Procedure Tracts of Pleural Mesothelioma: Incidence and Novel Risk Factors in 308 Patients"],"prefix":"10.3390","volume":"17","author":[{"given":"Moshe","family":"Lapidot","sequence":"first","affiliation":[{"name":"Division of Thoracic Surgery, Lung Center and International Mesothelioma Program, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, MA 02115, USA"},{"name":"Division of Thoracic Surgery, Galilee Medical Center, Nahariya 2210001, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuele","family":"Mazzola","sequence":"additional","affiliation":[{"name":"Dana Farber Cancer Institute, T.H Chan School of Public Health, Boston, Harvard Medical School, Boston, MA 02215, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3231-5491","authenticated-orcid":false,"given":"Raphael","family":"Bueno","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Lung Center and International Mesothelioma Program, Brigham and Women\u2019s Hospital and Harvard Medical School, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"152248","DOI":"10.1016\/j.anndiagpath.2023.152248","article-title":"The over Diagnosis of Diffuse Mesothelioma: An Analysis of 311 Cases with Recommendations for the Avoidance of Pitfalls","volume":"68","author":"Carney","year":"2024","journal-title":"Ann. 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