Epidemiology and clinical characteristics of mesothelioma in the Chinese population: a multicenter study

Mesothelioma is a rare and highly aggressive tumor that causes severe damage. However, there is a lack of systematic reports on the incidence and clinical characteristics of mesothelioma in the Chinese population.

This study aims to characterize the epidemiological features of mesothelioma in the Chinese population and to evaluate the effectiveness of current treatment strategies, to inform clinical decision-making and improve patient care.

The epidemiological characteristics of patients were collected by regional study centers according to the predefined inclusion and exclusion criteria. Asbestos exposure status was clearly identified for each patient, and treatment strategies were analyzed across mesothelioma cases with different primary tumor sites.

Data on mesothelioma patients and their treatment information were collected from 11 hospitals across China between January 2006 and December 2024. Epidemiological data and baseline characteristics were summarized using descriptive methods. The Kaplan-Meier method was used to analyze progression-free survival (PFS) and overall survival (OS). Key response indicators included the objective response rate (ORR) and disease control rate (DCR).

A total of 927 patients from 11 provinces in China were included in the analysis. The major types of mesothelioma observed were pleural mesothelioma (n = 537), peritoneal mesothelioma (n = 240), pericardial mesothelioma (n = 5), and mesothelioma of the tunica vaginalis testis (n = 5). Among these patients, 163 had confirmed asbestos exposure. For pleural mesothelioma, 45.6% (n = 245) of patients were from Yunnan Province. For peritoneal mesothelioma, 62.5% (n = 150) of patients were from Zhejiang Province. The median PFS rates for pleural and peritoneal mesothelioma patients were 6.6 and 5.7 months, respectively. The median OS was 16.6 months for pleural mesothelioma and 12.1 months for peritoneal mesothelioma. The ORR for pleural mesothelioma was 15%, with a DCR of 85.9%, while the ORR for peritoneal mesothelioma was 14.4%, with a DCR of 84.7%.

The incidence of mesothelioma in China exhibits distinct regional characteristics. Pleural mesothelioma is predominantly associated with crocidolite asbestos exposure in Yunnan Province, while peritoneal mesothelioma is linked to hand-spun chrysotile asbestos exposure in Zhejiang Province, with notable sex differences observed. No significant differences in treatment outcomes were identified between pleural and peritoneal mesothelioma patients undergoing first-line therapy. These findings highlight the importance of region-specific strategies for the diagnosis and treatment of mesothelioma in China.