在临床实践中，胸膜间皮瘤根治性手术后腹膜播散偶尔会复发。本研究调查了与胸膜间皮瘤胸膜切除/去皮质术后腹膜播散相关的危险因素和预后，这些因素很少报道。这项回顾性研究纳入了2011年1月至2021年12月期间因胸膜切除/去皮质后复发的160名患者。根据最初的复发模式对复发进行分类。 P组复发伴腹膜播散，非P组复发但无腹膜播散。该分析使用多变量逻辑回归分析确定腹膜播散的危险因素。使用Kaplan-Meier法和时序检验对生存进行分析。在160名患者中，20名（12.5％）表现出腹膜播散并被分配到P组，而140名（87.5％）复发但没有腹膜播散并被分配到P组。分配到非P组。多变量逻辑回归分析显示膈肌重建（比值比 [OR]，2.8；95% 置信区间 [CI]，1.0-8.0；p = 0.048）和女性（OR，3.7；95% CI 1.26-10.8；p = 0.017）与 P 组相关。 P 组的复发后生存率比非 P 组差（复发后 1 年生存率：22.2% vs. 65.3%；中位数：6.7 个月 vs. 19.4 个月；p = 0.0013）。发生腹膜播散胸膜间皮瘤胸膜切除/去皮质术后复发的患者中，大约有八分之一的患者出现这种情况，并且女性和接受膈肌重建的患者的发病率明显更高。此外，腹膜播散的术后复发与不良预后相关。© 2024。外科肿瘤学会。

In clinical practice, peritoneal dissemination after curative-intent surgery for pleural mesothelioma occasionally recurs. This study investigated the risk factors and prognosis associated with post-pleurectomy/decortication peritoneal dissemination in pleural mesothelioma, which are rarely reported.This retrospective review included 160 patients who experienced recurrence after pleurectomy/decortication for pleural mesothelioma between January 2011 and December 2021. Patients with recurrence were classified according to the initial recurrence pattern. The P group experienced recurrence with peritoneal dissemination, and the non-P group experienced recurrence without peritoneal dissemination. The analysis determined the risk factors for peritoneal dissemination using multivariable logistic regression analysis. Survival was analyzed using the Kaplan-Meier method and the log-rank test.Of the 160 patients, 20 (12.5%) exhibited peritoneal dissemination and were assigned to the P group, whereas 140 (87.5%) had recurrence without peritoneal dissemination and were assigned to the non-P group. Multivariable logistic regression analysis showed that diaphragm reconstruction (odds ratio [OR], 2.8; 95% confidence interval [CI], 1.0-8.0; p = 0.048) and female sex (OR, 3.7; 95% CI 1.26-10.8; p = 0.017) were associated with the P group. Post-recurrence survival was worse in the P group than in the non-P group (1-year post-recurrence survival: 22.2% vs. 65.3%; median: 6.7 months vs. 19.4 months; p = 0.0013).Peritoneal dissemination occurred in approximately one of every eight patients with recurrence after pleurectomy/decortication for pleural mesothelioma, and the incidence was significantly higher among females and patients undergoing diaphragm reconstruction. Moreover, postoperative recurrence of peritoneal dissemination was associated with a poor prognosis.© 2024. Society of Surgical Oncology.