Sahar A Saddoughi1, Zaid M Abdelsattar1, Shanda H Blackmon2. 1. Division of General Thoracic Surgery, Mayo Clinic, Rochester, Minnesota. 2. Division of General Thoracic Surgery, Mayo Clinic, Rochester, Minnesota. Electronic address: blackmon.shanda@mayo.edu.
Abstract
BACKGROUND: Malignant pleural mesothelioma (MPM) remains an aggressive malignancy that is difficult to cure. However, the treatment paradigm of MPM has evolved, and the national practice patterns are unknown. This study examined the national trends in the epidemiology, national treatment patterns, and survival of patients with this disease. METHODS: We identified all patients (n = 19,134) with MPM from the National Cancer Data Base from 2004 to 2013. We analyzed patient, tumor characteristics, and treatment patterns using descriptive statistics and used Kaplan-Meier and Cox proportional hazards models to estimate survival stratified by the type of therapy administered. RESULTS: Four histologic subtypes were represented in the National Cancer Data Base, these included sarcomatoid (n = 2,355 [12.3%]), epithelioid (n = 6,858 [35.8%]), biphasic (n = 13,617 [11%]), and not otherwise specified (n = 8,560 [44.7%]). Across all subtypes, the prevalence of mesothelioma was highest among white men. Sarcomatoid had the worst survival (adjusted hazard ratio, 2.2; p < 0.001). Most patients did not receive any specific modality of treatment (40.2%). Chemotherapy alone was the most common treatment used (31.8%). Trimodality treatment with chemotherapy, surgical resection, and radiation therapy was associated with the best survival (adjusted hazard ratio, 0.43; p < 0.001), followed by combination chemotherapy and resection (adjusted hazard ratio, 0.49; p < 0.001). CONCLUSIONS: This is the first publication to date to analyze the mesothelioma National Cancer Data Base. Although survival remains poor, multimodality therapy with surgical resection is associated with the best survival for MPM. Further research is needed to improve survival and overall patient outcomes.
BACKGROUND:Malignant pleural mesothelioma (MPM) remains an aggressive malignancy that is difficult to cure. However, the treatment paradigm of MPM has evolved, and the national practice patterns are unknown. This study examined the national trends in the epidemiology, national treatment patterns, and survival of patients with this disease. METHODS: We identified all patients (n = 19,134) with MPM from the National Cancer Data Base from 2004 to 2013. We analyzed patient, tumor characteristics, and treatment patterns using descriptive statistics and used Kaplan-Meier and Cox proportional hazards models to estimate survival stratified by the type of therapy administered. RESULTS: Four histologic subtypes were represented in the National Cancer Data Base, these included sarcomatoid (n = 2,355 [12.3%]), epithelioid (n = 6,858 [35.8%]), biphasic (n = 13,617 [11%]), and not otherwise specified (n = 8,560 [44.7%]). Across all subtypes, the prevalence of mesothelioma was highest among white men. Sarcomatoid had the worst survival (adjusted hazard ratio, 2.2; p < 0.001). Most patients did not receive any specific modality of treatment (40.2%). Chemotherapy alone was the most common treatment used (31.8%). Trimodality treatment with chemotherapy, surgical resection, and radiation therapy was associated with the best survival (adjusted hazard ratio, 0.43; p < 0.001), followed by combination chemotherapy and resection (adjusted hazard ratio, 0.49; p < 0.001). CONCLUSIONS: This is the first publication to date to analyze the mesothelioma National Cancer Data Base. Although survival remains poor, multimodality therapy with surgical resection is associated with the best survival for MPM. Further research is needed to improve survival and overall patient outcomes.
Authors: Hari B Keshava; Andrew Tang; Hafiz Umair Siddiqui; Siva Raja; Daniel P Raymond; Alejandro Bribriesco; James Stevenson; Sudish C Murthy; Usman Ahmad Journal: World J Surg Date: 2019-12 Impact factor: 3.352
Authors: Andrew D Newton; Jarrod D Predina; Christopher J Corbett; Lydia G Frenzel-Sulyok; Leilei Xia; E James Petersson; Andrew Tsourkas; Shuming Nie; Edward J Delikatny; Sunil Singhal Journal: J Am Coll Surg Date: 2018-11-22 Impact factor: 6.113
Authors: Kristin J Cummings; Michael J Becich; David J Blackley; Dennis Deapen; Robert Harrison; Raffit Hassan; S Jane Henley; Mary Hesdorffer; D Kevin Horton; Jacek M Mazurek; Harvey I Pass; Emanuela Taioli; Xiao-Cheng Wu; Marjorie G Zauderer; David N Weissman Journal: Am J Ind Med Date: 2019-11-19 Impact factor: 2.214