Prognostic factors and survival in malignant pleural mesothelioma

Malignant pleural mesothelioma is a lethal disease and little is known about prognostic factors. The prognostic significance of age, stage of disease, gender and histological subtype was studied in 167 new cases of cytologically (15%) or histologically (85%) proven malignant pleural mesothelioma in the Rotterdam area, during the period 1987-1989. Median survival of all patients was 242 days. Univariate analysis identified age, stage and histopathological subtype as significant prognostic factors, which was confirmed in multivariate analysis. Median survival rates for patients < 65, 65-74 and > or = 75 yrs were 359, 242 and 131 days, respectively. Patients with Stage I disease had a median survival of 359 days compared to 147 and 112 days, respectively, for patients with Stage II and the combination of Stages III and IV. Mixed histopathological subtype (190 days) was less favourable than sarcomatous (207 days) and epithelial (252 days) subtypes. Using a Cox proportional hazard model in patients with malignant pleural mesothelioma, age, histological subtype and stage were identified as independent prognostic factors. These prognostic factors should be taken into account when starting or evaluating treatment studies.