E Skammeritz1, L H Omland, J P Johansen, O Omland. 1. Danish Ramazzini Center, Department of Occupational Medicine, Aalborg Hospital, Aarhus University Hospital, Denmark. ellenskammeritz@gmail.com
Abstract
BACKGROUND: The natural history and etiology of malignant mesothelioma (MM) is already thoroughly described in the literature, but there is still debate on prognostic factors, and details of asbestos exposure and possible context with clinical and demographic data, have not been investigated comprehensively. OBJECTIVE: Description of patients with MM, focusing on exposure, occupation, survival and prognostic factors. METHODS: Review of medical records of patients with MM from 1984 to 2010 from a Danish Occupational clinic. Survival was estimated using Kaplan-Meier survival analysis and prognostic factors were identified by Cox regression analysis. RESULTS: 110 (90.2%) patients were male, and 12 (9.8%) were female. The median (interquartile rang [IQR]) age was 65 (13) years. Pleural MM was seen in 101 (82.8%) patients, and peritoneal in 11 (9.0%); two (1.6%) had MM to tunica vaginalis testis, and eight (6.6%) to multiple serosal surfaces. We found 68 (55.7%) epithelial tumors, 26 (21.3%) biphasic, and 6 (4.9%) sarcomatoid. 12 (9.8%) patients received tri-modal therapy, 66 (54.1%) received one-/two-modality treatment, and 36 (29.5%) received palliative care. Asbestos exposure was confirmed in 107 (91.0%) patients, probable in four (3.3%), and unidentifiable in 11 (9.0%). The median (IQR) latency was 42 (12.5) years. Exposure predominantly occurred in shipyards. The median overall survival was 1.05 (95% CI: 0.96-1.39) years; 5-year survival was 5.0% (95% CI: 2.0%-13.0%). Female sex, good WHO performance status (PS), epithelial histology and tri-modal treatment were associated with a favorable prognosis. CONCLUSION: MM continuously presents a difficult task diagnostically and therapeutically, and challenges occupational physicians with regard to identification and characterization of asbestos exposure.
BACKGROUND: The natural history and etiology of malignant mesothelioma (MM) is already thoroughly described in the literature, but there is still debate on prognostic factors, and details of asbestos exposure and possible context with clinical and demographic data, have not been investigated comprehensively. OBJECTIVE: Description of patients with MM, focusing on exposure, occupation, survival and prognostic factors. METHODS: Review of medical records of patients with MM from 1984 to 2010 from a Danish Occupational clinic. Survival was estimated using Kaplan-Meier survival analysis and prognostic factors were identified by Cox regression analysis. RESULTS: 110 (90.2%) patients were male, and 12 (9.8%) were female. The median (interquartile rang [IQR]) age was 65 (13) years. Pleural MM was seen in 101 (82.8%) patients, and peritoneal in 11 (9.0%); two (1.6%) had MM to tunica vaginalis testis, and eight (6.6%) to multiple serosal surfaces. We found 68 (55.7%) epithelial tumors, 26 (21.3%) biphasic, and 6 (4.9%) sarcomatoid. 12 (9.8%) patients received tri-modal therapy, 66 (54.1%) received one-/two-modality treatment, and 36 (29.5%) received palliative care. Asbestos exposure was confirmed in 107 (91.0%) patients, probable in four (3.3%), and unidentifiable in 11 (9.0%). The median (IQR) latency was 42 (12.5) years. Exposure predominantly occurred in shipyards. The median overall survival was 1.05 (95% CI: 0.96-1.39) years; 5-year survival was 5.0% (95% CI: 2.0%-13.0%). Female sex, good WHO performance status (PS), epithelial histology and tri-modal treatment were associated with a favorable prognosis. CONCLUSION: MM continuously presents a difficult task diagnostically and therapeutically, and challenges occupational physicians with regard to identification and characterization of asbestos exposure.
Authors: Manuela Valenzuela; Margarita Giraldo; Sonia Gallo-Murcia; Juliana Pineda; Laura Santos; Juan Pablo Ramos-Bonilla Journal: Curr Environ Health Rep Date: 2016-12
Authors: Assunta De Rienzo; Michael A Archer; Beow Y Yeap; Nhien Dao; Daniele Sciaranghella; Antonios C Sideris; Yifan Zheng; Alexander G Holman; Yaoyu E Wang; Paola S Dal Cin; Jonathan A Fletcher; Renee Rubio; Larry Croft; John Quackenbush; Peter E Sugarbaker; Kiara J Munir; Jesse R Battilana; Corinne E Gustafson; Lucian R Chirieac; Soo Meng Ching; James Wong; Liang Chung Tay; Stephen Rudd; Robert Hercus; David J Sugarbaker; William G Richards; Raphael Bueno Journal: Cancer Res Date: 2015-11-10 Impact factor: 12.701
Authors: Jennifer Faig; Suzanne Howard; Edward A Levine; Gary Casselman; Mary Hesdorffer; Jill A Ohar Journal: Transl Oncol Date: 2015-02 Impact factor: 4.243
Authors: Ana Sofia Fonseca; Amalie Kofoed Jørgensen; Bianca Xuan Larsen; Marina Moser-Johansen; Esben Meulengracht Flachs; Niels Erik Ebbehøj; Jakob Hjort Bønløkke; Trine Olesen Østergaard; Jesper Bælum; David Lee Sherson; Vivi Schlünssen; Harald William Meyer; Keld Alstrup Jensen Journal: Int J Environ Res Public Health Date: 2022-01-06 Impact factor: 3.390