P1.01-031 Does Malignant Pleual Mesothelioma (MPM) Behaviour Differ among Decades?

Abstract

MPM is extremely aggressive and has a long-latency period. Hence, detected at advanced stages resulting in an unfavorable prognosis (1-2years). However, MPM prognosis has been improving over the past few years with availability of better diagnostic and treatment regimens. We aim to compare clinico-pathologic characteristics of old-MPM cases referred to National Cancer Institute(NCI)-Cairo university between (2002-2003)and new MPM cases (2012-2015) Retrospective review of MPM cases presented to NCI. Data regarding demographics, histology, symptoms and signs, tumor staging and CT-findings were obtained from all patients’ records. Pearson's Chi(X2)and Fisher's Exact t-tests were used for statistical analysis. 1) Old cohort (n=100): 100 patients were encountered. Median age was 46 years. Males were 59% of cases. 30% has PS1. Asbestos exposure was documented in 74 cases. 44 cases were smokers, 25 cases were industrial-workers. Family history was positive in 12 cases. Dyspnea was the presenting symptom in 92 cases, chest pain in 83% and tuberculous pleuritis in 2 cases, effusion in all cases, pleural thickening in 80%, tracheal shift to the opposite-side in 23%, T2 represented 41%. Epithelioid subtype 46.6%. Pathological T2= 34%. 2) New cohort (n=194): 194 patients were encountered. Median age was 53 years. Males and females were nearly equally distributed. Epithelioid subtype was 63.4%. Rt-sided lesions were evident in nearly two-thirds of the cases. Pleural thickening was nodular in 131 (69.7%) cases. Inter-lobar fissure was thickened in 29.4%. Mediastinal Pleura was affected in 37.1%. Nearly, half of our cases had effusion. Ossification & calcification were detected in 8 (4.1%) cases. Contraction of hemithorax was identified in 77 (39.7%) cases. Chest wall invasion (CWI) was present in 18 (9.3%) cases. Pulmonary nodules were detected in one-fifth of the cohort. Metastases were detected in 9 (4.6%) cases (Figure). By comparing both groups, we found that more lymph node involvement(N+), less metastasis(M+),older median age, more females, more epithelial subtype, less pleural effusion presentation, more pleural thickening were detected in group 2(new cases) reflecting better staging ( mediastinoscopy& PET-CT),early detection, more incidence in females and better treatment modalities.