Michael Rosskamp1, Gilles Macq2, Kristiaan Nackaerts3, Marleen Praet4, Liesbet Van Eycken5, Jan P Van Meerbeeck6, Harlinde De Schutter7. 1. Belgian Cancer Registry, Rue Royale 2018, B-1210 Brussels, Belgium. Electronic address: michael.rosskamp@registreducancer.org. 2. Belgian Cancer Registry, Rue Royale 2018, B-1210 Brussels, Belgium. Electronic address: gilles.macq@registreducancer.org. 3. KU Leuven, University Hospitals Leuven, Pneumology Department, Herestraat 49, B-3000 Leuven, Belgium. Electronic address: kristiaan.nackaerts@uzleuven.be. 4. University Hospital of Ghent, Pathology Department, Belgian Mesothelioma Registry, De Pintelaan 185, B-9000 Ghent, Belgium. Electronic address: marleen.Praet@UGent.be. 5. Belgian Cancer Registry, Rue Royale 2018, B-1210 Brussels, Belgium. Electronic address: elizabeth.vaneycken@kankerregister.org. 6. Antwerp University Hospital, Department of Pulmonology, Wilrijkstraat 10, B-2650 Edegem, Belgium. Electronic address: Jan.VanMeerbeeck@uza.be. 7. Belgian Cancer Registry, Rue Royale 2018, B-1210 Brussels, Belgium. Electronic address: harlinde.DeSchutter@kankerregister.org.
Abstract
OBJECTIVES: Malignant pleural mesothelioma (MPM) is a rare and aggressive cancer, for which treatment is often limited to palliative combination chemotherapy. Multimodality-therapy, including radical surgery, is largely restricted to clinical trials, leaving its benefit currently unclear. This study aimed to get a comprehensive view on real-world MPM treatment at the Belgian population level, to assess survival and to identify prognostic factors. MATERIALS AND METHODS: The study period covered the incidence years 2004-2012 (N = 1453). Starting from the Belgian Cancer Registry, additional information regarding patient characteristics, diagnosis and treatment was retrieved from multiple data sources. Adjusted cox proportional-hazard regression models using time-dependent covariates were performed to assess survival in relation to treatment patterns and centre volume. RESULTS: Sixty-nine percent of patients underwent tumour-directed treatment, mostly cisplatin-pemetrexed chemotherapy. Radical surgery was mainly performed in younger patients with epithelioid subtype. Centre volume, surgery and chemotherapy showed a positive relation with survival in univariable analyses, but only chemotherapy remained significantly relevant in multivariable analyses. Younger patients, females, and epithelioid subtypes also independently had a better survival. CONCLUSION: This large population-based study provides insights in MPM treatment practice in Belgium. Centre volume and surgery being related to survival in univariable analyses, only chemotherapy remained prognostic after adjustment.
OBJECTIVES:Malignant pleural mesothelioma (MPM) is a rare and aggressive cancer, for which treatment is often limited to palliative combination chemotherapy. Multimodality-therapy, including radical surgery, is largely restricted to clinical trials, leaving its benefit currently unclear. This study aimed to get a comprehensive view on real-world MPM treatment at the Belgian population level, to assess survival and to identify prognostic factors. MATERIALS AND METHODS: The study period covered the incidence years 2004-2012 (N = 1453). Starting from the Belgian Cancer Registry, additional information regarding patient characteristics, diagnosis and treatment was retrieved from multiple data sources. Adjusted cox proportional-hazard regression models using time-dependent covariates were performed to assess survival in relation to treatment patterns and centre volume. RESULTS: Sixty-nine percent of patients underwent tumour-directed treatment, mostly cisplatin-pemetrexed chemotherapy. Radical surgery was mainly performed in younger patients with epithelioid subtype. Centre volume, surgery and chemotherapy showed a positive relation with survival in univariable analyses, but only chemotherapy remained significantly relevant in multivariable analyses. Younger patients, females, and epithelioid subtypes also independently had a better survival. CONCLUSION: This large population-based study provides insights in MPM treatment practice in Belgium. Centre volume and surgery being related to survival in univariable analyses, only chemotherapy remained prognostic after adjustment.