{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T16:33:15Z","timestamp":1791304395497,"version":"4.3.1"},"reference-count":24,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian National Institute for Insurance against Accidents at Work","award":["PB-0184"],"award-info":[{"award-number":["PB-0184"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Pericardial mesothelioma (PM) is an extremely rare cancer with a poor prognosis and no consensus on diagnostic and therapeutic management. We conducted a registry-based study on PM cases in Italy diagnosed between 1993 and 2021. Methods: Based on data from the Italian National Mesothelioma Registry (ReNaM), we performed a descriptive analysis of PM cases including clinical presentation, diagnostic work-up, asbestos exposure, and therapeutic management. Overall survival was calculated. Hazard ratios (HRs) and 95% confidence intervals (CI) for selected variables were estimated with univariate and multivariate Cox models. Results: We identified 72 cases (46 men and 26 women). Median age was 66 years (range 22\u201389). The most frequent histological subtypes were epithelioid and unspecified mesothelioma. Almost two-thirds of cases had been exposed to asbestos. The most common clinical presentation was pericardial effusion. Overall median survival was 2.8 months (95% CI 1.2\u20136.6) and older age at diagnosis was a negative prognostic factor. Clinical and treatment data were available for 47 patients (65%). Approximately one out of two patients underwent surgery (palliative, in one-third of cases). Adjuvant therapy was administered to seven patients (15%). In cases with treatment information, sarcomatoid subtype (HR 2.74, 95% CI: 1.06\u20137.06) was a negative prognostic factor; adjuvant therapy was associated with better survival (HR 0.38, 95% CI 0.14\u20131.02), but confounding by indication cannot be excluded. Conclusions: We confirmed the very poor prognosis of PM. An international network collecting PM cases with treatment information is needed to improve patient quality of life and survival.<\/jats:p>","DOI":"10.3390\/cancers17233865","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T11:29:30Z","timestamp":1764761370000},"page":"3865","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Pericardial Mesothelioma: Diagnostic and Therapeutic Management, a Population-Based Study in Italy"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4276-2583","authenticated-orcid":false,"given":"Simona","family":"Stella","sequence":"first","affiliation":[{"name":"COR Lombardia, Occupational Health Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8935-3843","authenticated-orcid":false,"given":"Dario","family":"Consonni","sequence":"additional","affiliation":[{"name":"COR Lombardia, Occupational Health Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8599-0629","authenticated-orcid":false,"given":"Giovanni Luca","family":"Ceresoli","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Humanitas Gavazzeni Clinic, 24125 Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Dallari","sequence":"additional","affiliation":[{"name":"COR Lombardia, Occupational Health Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5428-7225","authenticated-orcid":false,"given":"Riccardo","family":"Perduri","sequence":"additional","affiliation":[{"name":"COR Mesoteliomi Emilia Romagna, AUSL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cinzia","family":"Storchi","sequence":"additional","affiliation":[{"name":"COR Mesoteliomi Emilia Romagna, AUSL-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0121-6295","authenticated-orcid":false,"given":"Enrica","family":"Migliore","sequence":"additional","affiliation":[{"name":"COR Piemonte, AOU Citt\u00e0 della Salute e della Scienza di Torino and University of Turin, 10124 Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Gangemi","sequence":"additional","affiliation":[{"name":"COR Piemonte, AOU Citt\u00e0 della Salute e della Scienza di Torino and University of Turin, 10124 Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3690-8582","authenticated-orcid":false,"given":"Carlo","family":"Genova","sequence":"additional","affiliation":[{"name":"COR Liguria, Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, Dipartimento di Medicina Interna e Specialit\u00e0 Mediche, Universit\u00e0 degli Studi di Genova, 16132 Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Benfatto","sequence":"additional","affiliation":[{"name":"COR Liguria, Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, Dipartimento di Medicina Interna e Specialit\u00e0 Mediche, Universit\u00e0 degli Studi di Genova, 16132 Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"Comiati","sequence":"additional","affiliation":[{"name":"COR Veneto, Azienda Zero, 35131 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Zabeo","sequence":"additional","affiliation":[{"name":"COR Veneto, Azienda Zero, 35131 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4198-7035","authenticated-orcid":false,"given":"Sara","family":"Piro","sequence":"additional","affiliation":[{"name":"COR Toscana, Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139 Firenze, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4326-3615","authenticated-orcid":false,"given":"Lucia","family":"Giovannetti","sequence":"additional","affiliation":[{"name":"COR Toscana, Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139 Firenze, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1131-4286","authenticated-orcid":false,"given":"Iolanda","family":"Grappasonni","sequence":"additional","affiliation":[{"name":"COR Marche, School of Medicinal and Health Products Sciences, University of Camerino, 62032 Camerino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristiana","family":"Pascucci","sequence":"additional","affiliation":[{"name":"COR Marche, School of Medicinal and Health Products Sciences, University of Camerino, 62032 Camerino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7717-0417","authenticated-orcid":false,"given":"Francesca","family":"Larese Filon","sequence":"additional","affiliation":[{"name":"COR Friuli Venezia Giulia, Clinical Unit of Occupational Medicine, University of Trieste, 34127 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flavia","family":"D\u2019Agostin","sequence":"additional","affiliation":[{"name":"COR Friuli Venezia Giulia, Clinical Unit of Occupational Medicine, University of Trieste, 34127 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4072-2871","authenticated-orcid":false,"given":"Luigi","family":"Vimercati","sequence":"additional","affiliation":[{"name":"COR Puglia, Section of Occupational Medicine \u2018B Ramazzini\u2019, Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70121 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0313-9799","authenticated-orcid":false,"given":"Ilaria","family":"Cozzi","sequence":"additional","affiliation":[{"name":"COR Lazio, Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, 00139 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franco","family":"Calista","sequence":"additional","affiliation":[{"name":"COR Molise, Molise Regional Health Authority Campobasso, 86100 Campobasso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Cascone","sequence":"additional","affiliation":[{"name":"COR Sicilia, Cancer Registry ASP Ragusa and Sicily Regional Epidemiological Observatory, 97100 Ragusa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1213-6602","authenticated-orcid":false,"given":"Italo Francesco","family":"Angelillo","sequence":"additional","affiliation":[{"name":"COR Campania, Dipartimento di Medicina Sperimentale, Universit\u00e0 degli Studi della Campania \u201cLuigi Vanvitelli\u201d, 80138 Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0435-600X","authenticated-orcid":false,"given":"Alessandra","family":"Binazzi","sequence":"additional","affiliation":[{"name":"DIMEILA, Department of Occupational and Environmental Medicine, Epidemiology, Hygiene, National Institute for Insurance against Accidents at Work (INAIL), 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9068-2137","authenticated-orcid":false,"given":"Alessandro","family":"Marinaccio","sequence":"additional","affiliation":[{"name":"DIMEILA, Department of Occupational and Environmental Medicine, Epidemiology, Hygiene, National Institute for Insurance against Accidents at Work (INAIL), 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9075-3684","authenticated-orcid":false,"given":"Carolina","family":"Mensi","sequence":"additional","affiliation":[{"name":"COR Lombardia, Occupational Health Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,1]]},"reference":[{"key":"ref_1","first-page":"100804","article-title":"Trends in Mesothelioma Mortality in the United States Between 1999 and 2020","volume":"6","author":"Didier","year":"2025","journal-title":"JTO Clin. 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Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e152","DOI":"10.1016\/j.cllc.2018.11.008","article-title":"Treatment and Outcomes of Primary Pericardial Mesothelioma: A Contemporary Review of 103 Published Cases","volume":"20","author":"McGehee","year":"2019","journal-title":"Clin. Lung Cancer"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1016\/j.annepidem.2017.04.001","article-title":"Epidemiology of mesothelioma of the pericardium and tunica vaginalis testis","volume":"27","author":"Mezei","year":"2017","journal-title":"Ann. Epidemiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"609","DOI":"10.5271\/sjweh.3895","article-title":"Association between asbestos exposure and pericardial and tunica vaginalis testis malignant mesothelioma: A case-control study and epidemiological remarks","volume":"46","author":"Marinaccio","year":"2020","journal-title":"Scand. J. Work. Environ. 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Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.lungcan.2022.03.012","article-title":"First-line nivolumab plus ipilimumab versus chemotherapy for the treatment of unresectable malignant pleural mesothelioma: Patient-reported outcomes in CheckMate 743","volume":"167","author":"Scherpereel","year":"2022","journal-title":"Lung Cancer"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1016\/j.annonc.2022.01.074","article-title":"First-line nivolumab plus ipilimumab versus chemotherapy in patients with unresectable malignant pleural mesothelioma: 3-year outcomes from CheckMate 743","volume":"33","author":"Peters","year":"2022","journal-title":"Ann. Oncol."},{"key":"ref_24","first-page":"e19966","article-title":"Primary Pericardial Mesothelioma: A Rare but Serious Consideration","volume":"13","author":"Seal","year":"2021","journal-title":"Cureus"}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/17\/23\/3865\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T11:40:57Z","timestamp":1764762057000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/17\/23\/3865"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,1]]},"references-count":24,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["cancers17233865"],"URL":"https:\/\/doi.org\/10.3390\/cancers17233865","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,1]]}}}