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Published on: December 21, 2019
Prognostic factors for progression-free and overall survival in malignant pleural mesothelioma
Jordi Guzmán-Casta1, Sonia Carrasco-CaraChards2, Jorge Guzmán-Huesca3
1Clinic of Thoracic Oncology, Instituto Nacional de Enfermedades Respiratorias, Dr. Ismael Cosío Villegas, Ciudad de México, Mexico.
Background:
Malignant pleural mesothelioma is an infrequent neoplasia with a poor prognosis and the majority of patients already have advanced disease at the time of presentation. Exposure to asbestos is the most important risk factor for malignant pleural mesothelioma. Mesothelioma is a neoplasia with a long preclinical stage that can span from 15 to 40 years.
Methods:
This was a descriptive, observational, retrospective study of 136 patients with a confirmed diagnosis of mesothelioma, which compared histological subtypes, immunohistochemical biomarkers, concomitant chronic degenerative diseases, tobacco use, age at the time of diagnosis, clinical stage and chemotherapy agents used or other treatments such as radiotherapy and surgery to identify all the factors that impact in the prognosis of overall survival (OS) and progression-free survival (PFS).
Results:
A total of 136 patients were included in the study. In the total study population, 84 patients were male (61.8%) and 52 were female (38.2%). Median PFS was nine months (95% confidence interval [CI]: 8.4-9.5 months) and median OS was 12 months (95% CI: 11.3-12.6). The results indicated that the most determining prognostic factors for OS and PFS were cell differentiation measured by immunohistochemical biomarkers, the treatment chosen, and that RECIST was the most significant in the evaluation of patient response to treatment.
Conclusions:
Malignant pleural mesothelioma is a cancer with a poor prognosis usually diagnosed at an advanced stage of disease. Our study revealed that the prognostic factors for OS and PS were cell differentiation, the treatment chosen and RECIST.
Insights
Malignant pleural mesothelioma, a cancer with poor prognosis, is often diagnosed late. Cell differentiation, treatment choice, and RECIST evaluation significantly impact patient survival and progression-free survival.
Area of Science:
- Oncology
- Thoracic Medicine
- Cancer Research
Background:
- Malignant pleural mesothelioma is a rare cancer with a poor prognosis, frequently diagnosed at advanced stages.
- Asbestos exposure is the primary risk factor, and the disease has a long preclinical phase (15-40 years).
Purpose of the Study:
- To identify prognostic factors influencing overall survival (OS) and progression-free survival (PFS) in malignant pleural mesothelioma.
- To compare histological subtypes, biomarkers, comorbidities, lifestyle factors, and treatment modalities.
Main Methods:
- A retrospective, observational study of 136 patients with confirmed mesothelioma.
- Analysis included histological subtypes, immunohistochemical biomarkers, comorbidities, tobacco use, age, clinical stage, and treatments (chemotherapy, radiotherapy, surgery).
Main Results:
- Median PFS was 9 months and median OS was 12 months in the study population.
- Key prognostic factors for OS and PFS included cell differentiation (via immunohistochemistry) and chosen treatment.
- RECIST (Response Evaluation Criteria in Solid Tumors) was significant for evaluating treatment response.
Conclusions:
- Malignant pleural mesothelioma has a poor prognosis and is often diagnosed late.
- Cell differentiation, treatment selection, and RECIST evaluation are crucial prognostic indicators for patient outcomes.
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