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The clinicopathological characteristics with long-term outcomes in malignant mesothelioma

Mutlu Dogan¹, Gungor Utkan, Cemil Hocazade

¹Department of Medical Oncology, Ankara Numune Training and Research Hospital, 06100, Altindag, Ankara, Turkey, mutludogan1@yahoo.com.

Medical Oncology (Northwood, London, England)

|September 12, 2014

Abstract:

Malignant mesothelioma (MM) is a neoplasm which originates from serous membranes. It is relatively more common in Turkey. Ninety-nine patients between 2002-2009 were evaluated for survival and patient characteristics with chest pain, dyspnea, weight loss, loss of appetite, anemia, leukocytosis, thrombocytosis and lactate dehydrogenase (LDH) elevation, retrospectively. Male/female ratio was 1.41(58/41). Median age was 53(27-88). Asbestosis exposure rate was 78.5%. Most of the patients had better ECOG-PS (88.7% for 1-2). Chest pain (47.7%), dyspnea (44.8%), weight loss (49%), loss of appetite (50%), anemia (38%), leukocytosis (37.2%), thrombocytosis (26.6%) and LDH elevation (10.1%) were found with median values such as 11.8 g/dL (5-17.1) for hemoglobin, 8,800/mm3 for WBC (2,600-38,300), 382,000/mm(3) for platelets (28,000-1,504,000) and 253 IU/L for LDH (85-1,877), respectively. The most common site was pleura (62.3%). Half of the patients were unclassified, while epitheloid histopathology (39.4%) was most common in classified ones. RT rate was 42.1% in operated patients and all had pleural MM. Median OS was 22.9 months. Eighty percent of the patients had first-line CT with a clinical benefit rate of 63.3%. Second-line CT rate was 29% with a clinical benefit rate of 44%. Most preferred CT regimen was cisplatinum and pemetrexed. Most of the patients were male in their 50 s with pleural MM. They had chest pain, dyspnea, weight loss and loss of appetite as the most common symptoms at diagnosis. Only half of the patients could be subtyped with a predominance of epitheloid histology.

Insights

Malignant mesothelioma (MM) is a rare cancer affecting serous membranes, more common in Turkey. This study analyzed 99 patients, revealing male predominance, median age 53, and high asbestosis exposure, with pleural MM being most frequent.

Area of Science:

Oncology
Thoracic Surgery
Medical Research

Background:

Malignant mesothelioma (MM) is a rare neoplasm originating from serous membranes, with a notable prevalence in Turkey.
Understanding patient characteristics and survival outcomes is crucial for improving management strategies for this aggressive cancer.

Purpose of the Study:

To retrospectively evaluate survival and patient characteristics of malignant mesothelioma (MM) cases.
To identify common symptoms, risk factors, histopathology, and treatment responses in MM patients.

Main Methods:

Retrospective analysis of 99 malignant mesothelioma (MM) patients diagnosed between 2002-2009.
Evaluation of patient demographics, clinical symptoms (chest pain, dyspnea, weight loss, appetite loss), laboratory findings (anemia, leukocytosis, thrombocytosis, LDH), asbestosis exposure, ECOG-PS, tumor site, histopathology, and treatment regimens (chemotherapy, RT).
Survival analysis, including overall survival (OS) and clinical benefit rates for first- and second-line chemotherapy.

Main Results:

The study included 99 patients (Male/Female ratio 1.41), median age 53, with a high asbestosis exposure rate (78.5%).
Common symptoms were weight loss (49%), loss of appetite (50%), chest pain (47.7%), and dyspnea (44.8%). Pleural MM was the most common site (62.3%).
Median OS was 22.9 months. First-line chemotherapy (80% of patients) showed a 63.3% clinical benefit rate, with cisplatin and pemetrexed being the preferred regimen.

Conclusions:

Malignant mesothelioma (MM) predominantly affects males in their 50s, often presenting with constitutional symptoms and pleural involvement.
A significant proportion of patients could not be subtyped, highlighting diagnostic challenges, though epithelioid histology was most common.
Chemotherapy, particularly cisplatin and pemetrexed, demonstrated clinical benefit in both first- and second-line settings for MM patients.

Read full analysis

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