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Management of malignant pleural mesothelioma - part 3 : Data from the Austrian Mesothelioma Interest Group (AMIG)
Thomas Klikovits1, Mir Alireza Hoda2, Yawen Dong1
1Division of Thoracic Surgery, Department of Surgery, Comprehensive Cancer Center, Medical University Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Background:
Malignant pleural mesothelioma (MPM) is a rare but aggressive tumor originating from the pleural cavity with a strong link to previous asbestos exposure. In order to determine the demographics, diagnostics, therapeutic strategies, and prognosis of MPM patients in Austria, the Austrian Mesothelioma Interest Group (AMIG) was founded in 2011. In this report the data from the AMIG MPM database collected to date are reported.
Methods:
A prospective observational registry was initiated, including patients with histologically verified MPM diagnosed and treated at specialized centers in Austria. Patient inclusion started in January 2011 and follow-up was completed until September 2015.
Results:
A total number of 210 patients were included. There were 167 male and 43 female patients with a mean age of 67.0 years (SD ± 11.3) at the time of diagnosis. Asbestos exposure was confirmed in 109 (69.4 %) patients. The histological subtype was epithelioid in 141 (67.2 %), sarcomatoid in 16 (7.6 %), biphasic in 28 (13.3 %), and MPM not otherwise specified in 25 (11.9 %) patients. Of the patients, 30 (14.3 %) received best supportive care (BSC) only, 71 (33.8 %) chemotherapy (CHT) alone, four (1.9 %) radiotherapy (RT) alone, 23 (11.9 %) CHT/RT, two (0.9 %) surgery alone, and 76 (36.2 %) curative surgery within a multimodality treatment (MMT), which was more frequently performed for patients younger than 65 years and with early-stage disease (I + II). Median overall survival (OS) was 19.1 months (95 % CI 14.7-23.5). The 1‑, 3‑, and 5‑year OS rates were 66 %, 30 %, and 23 %, respectively, and OS was significantly better in patients undergoing surgery within MMT (5-year survival 5 % vs. 40 %, p = 0.001).
Conclusion:
Patients with earlier disease stages, younger age, good performance status, and epithelioid histology were more likely to undergo MMT including surgery, which resulted in a more favorable outcome.
Insights
Malignant pleural mesothelioma (MPM) survival is improved with multimodality treatment (MMT) including surgery, particularly for younger patients with early-stage disease. MMT offers a more favorable outcome for eligible MPM patients.
Area of Science:
- Oncology
- Epidemiology
- Thoracic Surgery
Background:
- Malignant pleural mesothelioma (MPM) is a rare, aggressive cancer linked to asbestos exposure.
- The Austrian Mesothelioma Interest Group (AMIG) was established to analyze MPM demographics, diagnostics, treatments, and prognosis in Austria.
- This report presents data from the AMIG MPM database collected from 2011 to 2015.
Purpose of the Study:
- To determine the demographics, diagnostic approaches, therapeutic strategies, and survival outcomes of MPM patients in Austria.
- To evaluate the impact of different treatment modalities, including multimodality treatment (MMT) with surgery, on patient prognosis.
Main Methods:
- A prospective observational registry was established, including patients with histologically confirmed MPM.
- Data were collected from specialized centers in Austria between January 2011 and September 2015.
- Patient characteristics, treatment strategies, and overall survival (OS) were analyzed.
Main Results:
- A total of 210 patients (167 male, 43 female; mean age 67.0 years) were included.
- Asbestos exposure was confirmed in 69.4% of patients. Epithelioid histology was most common (67.2%).
- Multimodality treatment (MMT) including surgery was associated with significantly better overall survival (5-year OS 40% vs. 5% for non-surgical MMT, p=0.001).
Conclusions:
- Patients with earlier disease stages, younger age, good performance status, and epithelioid histology were more likely to receive MMT.
- MMT, particularly when including surgery, resulted in a more favorable prognosis for MPM patients.
- These findings highlight the importance of selecting appropriate candidates for aggressive treatment strategies.
