Abstract
Background: malignant pleural mesothelioma (MPM) is characterized by long latency period between exposure to asbestos and development of the disease so we hypothesize that MPM in the young has different characteristics. Patients and Methods: This is a retrospective study including all eligible patients with malignant pleural mesothelioma presenting to National Cancer Institute, Cairo University during the period from 2008 to 2013. Patients were divided into two groups: Group 1: patients aged ≤45 years. Group 2: Patients aged >45 years. Both groups were assessed regarding different clinicpathological features. Primary Objectives: comparison of different epidemiological features of both groups. Secondary Objectives: assessment of clinical response (CR), progression free survival (PFS) and overall survival (OS) in both groups. Results: 102 Patients were included with median follow up of 14.4 months. Group (1) included 35 patients with mean age 40 ± 3.65 years (31 to 45 years). Group (2) included 67 patients with mean age of 58.6 ± 8.5 years (46 to 87 years). 68% of group (1) came from endemic areas which is significantly higher than group (2): (35.8%), p = 0.02. History of Asbestos exposure was highly significantly different between the 2 groups, 77.1% in group (1) versus 38.8% in group (2), p < 0.001. Other factors showed no significant differences between the two groups. Overall clinical response (CR + PR) was 20% in group (1) versus 17.9% in group (2). P = 0.7. There was a trend towards longer median PFS in young patients, (19.8 ± 8.4 versus 6.9 ± 1.4 months). p = 0.09. The median OS of young patients is significantly longer (20.6 ± 6.3 months) than older patients (11.4 ± 3.6). p = 0.05. Conclusions: Mesothelioma in the young is more sensitive to asbestos exposure, has better OS and likely a different disease entity which needs further studies to understand its underlying biological features.
Highlights
IntroductionMesothelioma is a rare cancer that is estimated to occur in approximately 2500 people is US every year [1]
Mesothelioma in the young is more sensitive to asbestos exposure, has better overall survival (OS) and likely a different disease entity which needs further studies to understand its underlying biological features
Malignant pleural mesothelioma is the most common type, it can occur in lining of other sites e.g. peritoneum, pericardium, tunica vaginalis testis
Summary
Mesothelioma is a rare cancer that is estimated to occur in approximately 2500 people is US every year [1]. Malignant pleural mesothelioma is the most common type, it can occur in lining of other sites e.g. peritoneum, pericardium, tunica vaginalis testis. Malignant pleural mesothelioma occurs mainly in older men (median age is 72 years) who have exposed to asbestos it occurs decades after exposure (20 to 40 years later) [3] [4] [5] [6]. Considering the long latency period from exposure to asbestos to disease development it is hypothesized that malignant pleural mesothelioma in young age is less likely to be caused by asbestos exposure and that other factors may attribute to the disease process such as genetic predisposition or exposure to other environmental carcinogens. It is important to understand the clinico-pathological features of malignant pleural mesothelioma in this particular age group
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