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Malignant pleural mesothelioma: a single-center experience in Turkey
Ahmet Sezer1, Ahmet Taner Sümbül2, Hüseyin Abalı1
1Department of Medical Oncology, Başkent University, Medical Faculty, Adana, Turkey.
Background:
Malignant pleural mesothelioma is a rare lethal malignancy caused by asbestos exposure. It is more frequently seen in certain regions in Turkey. In this retrospective study, we aimed to analyse demographic, clinical, and pathological data and treatment-related features in 54 patients.
Material And Methods:
The study included 54 patients diagnosed with malignant mesothelioma that were followed and treated.
Result:
Of the 54 patients, 34 (55.6%) were male. The median age in men and women were 60.3 (38.2-77.2) and 65.8 (37.7-77.5) years, respectively. In 35 (64.8%), exposure to asbestosis was present. Epithelial type was found in 27 (50.0%), followed by mixed type in 7 (13.0%) patients, and in 20 (37.0%) patients the subtype could not be determined. The disease was staged as IV in 37 (68.5%) patients. In 28 patients (51.9%), it was right-sided and in 1 (1.9%) it was bilateral. The most frequent metastatic sites (in decreasing order) were lungs, mediastinum, diaphragm, liver, and thoracal wall. Of the 54 patients, 36 (66.6%) received 1st-line chemotherapy and 20 (37%) 2nd-line chemotherapy. Eighteen patients (33.3%) received radiotherapy; 11 (20.3%) with palliative intention and 7 (12.9%) with curative intention. Median overall survival (OS) was 12.03 months (95% CI 7.2-16.8). OS was not affected by sex (p=0.32), smoking history (p=0.51), alcohol consumption (p=0.36), family history (p=0.67), pleural effusion presence (p=0.80), operation (p=0.14), clinical stage (p=0.072), symptom at presentation (p=0.66), having mixed type histology (p=0.079), asbestos exposure (p=0.06), and type of 1st-line chemotherapy (p=0.161). On the contrary, it may be positively affected by good ECOG PS (0-1) (p<0.01), age below 65 (p=0.03), left-sided disease (p=0.01), receiving chemotherapy (p<0.01), having unilateral pleural effusion (p=0.018), and type of 2nd-line chemotherapy (p=0.025).
Conclusions:
OS of our patients was better than that found in the literature, seeming to be positively affected by early stages, better ECOG PS, age below 65 years, left side involvement, and having second-line chemotherapy with cisplatin-gemcitabine or 3M. Overall treatment success seems to be comparable to what is currently expected.
Insights
Malignant pleural mesothelioma survival was better than expected, influenced by factors like early stage, good performance status, younger age, left-sided disease, and second-line chemotherapy. Treatment success aligns with current expectations for this asbestos-related cancer.
Area of Science:
- Oncology
- Pulmonology
- Environmental Health
Background:
- Malignant pleural mesothelioma is a rare, lethal cancer linked to asbestos exposure.
- Prevalence is notably higher in specific regions of Turkey.
- This study analyzes demographic, clinical, and treatment data of 54 patients.
Purpose of the Study:
- To analyze demographic, clinical, and pathological features of malignant pleural mesothelioma patients.
- To evaluate treatment-related factors and their impact on patient outcomes.
- To compare overall survival (OS) with existing literature data.
Main Methods:
- Retrospective analysis of 54 patients diagnosed with malignant mesothelioma.
- Data collection included patient demographics, clinical presentation, asbestos exposure, histology, staging, and treatment modalities (chemotherapy, radiotherapy).
- Statistical analysis to determine factors affecting overall survival.
Main Results:
- The majority of patients (64.8%) had a history of asbestos exposure.
- Epithelial type was the most common histology (50.0%), with stage IV disease in 68.5% of patients.
- Median overall survival was 12.03 months. Factors positively impacting OS included good Eastern Cooperative Oncology Group Performance Status (ECOG PS), age under 65, left-sided disease, receiving chemotherapy, unilateral pleural effusion, and specific second-line chemotherapy regimens.
Conclusions:
- Overall survival in this cohort exceeded literature benchmarks.
- Positive survival predictors include early disease stage, better ECOG PS, younger age, left-sided involvement, and second-line chemotherapy (cisplatin-gemcitabine or 3M).
- Treatment success appears comparable to current expectations for malignant pleural mesothelioma.