Abstract
Background: Malignant mesothelioma (MM) is a rare but deadly malignancy with about 3,000 new cases being diagnosed each year in the US. Very few studies have been performed to analyze factors associated with mesothelioma survival, especially for peritoneal presentation. The overarching aim of this study is to examine survival of the cohort of patients with malignant mesothelioma enrolled in the National Mesothelioma Virtual Bank (NMVB). Methods: 888 cases of pleural and peritoneal mesothelioma cases were selected from the NMVB database, which houses data and associated biospecimens for over 1400 cases that were diagnosed from 1990 to 2017. Kaplan Meier's method was performed for survival analysis. The association between prognostic factors and survival was estimated using Cox Hazard Regression method and using R software for analysis. Results: The median overall survival (OS) rate of all MM patients, including pleural and peritoneal mesothelioma cases is 15 months (14 months for pleural and 31 months for peritoneal). Significant prognostic factors associated with improved survival of malignant mesothelioma cases in this NMVB cohort were younger than 45, female gender, epithelioid histological subtype, stage I, peritoneal occurrence, and having combination treatment of surgical therapy with chemotherapy. Combined surgical and chemotherapy treatment was associated with improved survival of 23 months in comparison to single line therapies. Conclusions: There has not been improvement in the overall survival for patients with malignant mesothelioma over many years with current available treatment options. Our findings show that combined surgical and chemotherapy treatment in peritoneal mesothelioma is associated with improved survival compared to local therapy alone.
Highlights
Malignant mesothelioma is a rare and fatal malignancy, associated with occupational and environmental exposure to asbestos
Despite regulations aimed to ban the industrial use of asbestos by US Occupational Safety and Health Administration (OSHA) in 1970, data do not suggest a decline in the incidence of malignant mesothelioma in the U.S.5
The focus of this study has been on the exploration of risk factors affecting mortality in the states of Pennsylvania and New York, which represent a region with an aging population, environmental concerns, well documented history of asbestos exposure, and other risk factors associated with mesothelioma development
Summary
Malignant mesothelioma is a rare and fatal malignancy, associated with occupational and environmental exposure to asbestos. Mesotheliomas develops in carriers of germline mutations of BAP1 (Carbone M., Kanodia S., JTO 20166, and mutations of BAP1 may increase susceptibility to low doses of asbestos and other mineral fibers (Napolitano A., Pellegrini L., et al). Mesotheliomas develops in carriers of germline mutations of BAP1 (Carbone M., Kanodia S., JTO 20166, and mutations of BAP1 may increase susceptibility to low doses of asbestos and other mineral fibers (Napolitano A., Pellegrini L., et al7) These issues are important to understand the reasons of the current ongoing mesothelioma epidemic and given the different prognosis and survival of mesotheliomas occurring in carriers of BAP1 mutations. Results: The median overall survival (OS) rate of all MM patients, version 3 (revision)
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