Sanna Laaksonen1,2, Ilkka Ilonen1,3, Eeva Kuosma1, Eva Sutinen1,4, Henrik Wolff5, Tapio Vehmas1,5, Kirsti Husgafvel-Pursiainen5, Jarmo A Salo1,3, Katri Koli1,6, Jari Räsänen1,3, Marjukka Myllärniemi1,4. 1. a Faculty of Medicine , University of Helsinki , Helsinki , Finland. 2. b Department of Pathology , University of Helsinki, and HUSLAB, Helsinki University Hospital , Helsinki , Finland. 3. c Department of General Thoracic and Esophageal Surgery , Heart and Lung Center, Helsinki University Hospital , Helsinki , Finland. 4. d Department of Pulmonary Medicine , Heart and Lung Center, Helsinki University Hospital , Helsinki , Finland. 5. e Occupational Medicine , Finnish Institute of Occupational Health , Helsinki , Finland. 6. f Research Programs Unit , Translational Cancer Biology, University of Helsinki , Helsinki , Finland.
Abstract
BACKGROUND: Malignant pleural mesothelioma (MPM) is a rare occupational cancer with a poor prognosis. Even with a multimodality treatment approach, the treatment outcomes remain unsatisfactory. The use of asbestos has been banned in most developed countries, but MPM continues to be a significant occupational disease also in these countries. Aim of this study is to identify modern epidemiology and assess equality in care. METHODS: Our study cohort consists of 1010 patients diagnosed with MPM in Finland during 2000-2012. The data were collected from the Finnish Cancer Registry, the National Workers' Compensation Center Registry and the National Registry of Causes of Death, Statistics Finland. RESULTS: Women were diagnosed a mean of 4.5 years later than males (p = .001), but survival did not differ (overall median survival 9.7 months). A workers' compensation claim was more common in males (OR 11.0 [95% CI 7.5-16.2]) and in regions with a major asbestos industry (OR 1.7 [95% CI 1.3-2.2]). One-year and three-year survivals did not differ regionally. Patients without chemotherapy treatment had an inferior survival (RR 1.8 [95% CI 1.5-2.0]). The initial survival benefit gained with pemetrexed was diluted at 51 months. CONCLUSIONS: MPM is a disease with a poor prognosis, although chemotherapy appears to improve survival time. Significant gender and regional variation exists among patients, with notable differences in diagnostic and treatment practices. Long-term outcomes with pemetrexed remain indeterminate. IMPACT: Emphasize centralized consult services for the diagnosis, treatment and support that patients receive for MPM, facilitating equal outcomes and compensation.
BACKGROUND:Malignant pleural mesothelioma (MPM) is a rare occupational cancer with a poor prognosis. Even with a multimodality treatment approach, the treatment outcomes remain unsatisfactory. The use of asbestos has been banned in most developed countries, but MPM continues to be a significant occupational disease also in these countries. Aim of this study is to identify modern epidemiology and assess equality in care. METHODS: Our study cohort consists of 1010 patients diagnosed with MPM in Finland during 2000-2012. The data were collected from the Finnish Cancer Registry, the National Workers' Compensation Center Registry and the National Registry of Causes of Death, Statistics Finland. RESULTS:Women were diagnosed a mean of 4.5 years later than males (p = .001), but survival did not differ (overall median survival 9.7 months). A workers' compensation claim was more common in males (OR 11.0 [95% CI 7.5-16.2]) and in regions with a major asbestos industry (OR 1.7 [95% CI 1.3-2.2]). One-year and three-year survivals did not differ regionally. Patients without chemotherapy treatment had an inferior survival (RR 1.8 [95% CI 1.5-2.0]). The initial survival benefit gained with pemetrexed was diluted at 51 months. CONCLUSIONS: MPM is a disease with a poor prognosis, although chemotherapy appears to improve survival time. Significant gender and regional variation exists among patients, with notable differences in diagnostic and treatment practices. Long-term outcomes with pemetrexed remain indeterminate. IMPACT: Emphasize centralized consult services for the diagnosis, treatment and support that patients receive for MPM, facilitating equal outcomes and compensation.
Authors: Hely Ollila; Mikko I Mäyränpää; Lassi Paavolainen; Juuso Paajanen; Katja Välimäki; Eva Sutinen; Henrik Wolff; Jari Räsänen; Olli Kallioniemi; Marjukka Myllärniemi; Ilkka Ilonen; Teijo Pellinen Journal: Front Oncol Date: 2022-06-20 Impact factor: 5.738
Authors: Paulus Torkki; Juuso Paajanen; Ville Kytö; Sanna Laaksonen; Jari Räsänen; Marjukka Myllärniemi; Ilkka Ilonen Journal: Thorac Cancer Date: 2021-09-13 Impact factor: 3.500
Authors: Hely Ollila; Juuso Paajanen; Henrik Wolff; Ilkka Ilonen; Eva Sutinen; Katja Välimäki; Arne Östman; Sisko Anttila; Eeva Kettunen; Jari Räsänen; Olli Kallioniemi; Marjukka Myllärniemi; Mikko I Mäyränpää; Teijo Pellinen Journal: J Pathol Clin Res Date: 2021-05-06