Prognostic factors and treatment outcomes of malignant pleural mesothelioma in Eastern Asian patients – A Taiwanese study
Journal
Journal of the Formosan Medical Association
Journal Volume
118
Journal Issue
1P2
Pages
230-236
Date Issued
2019
Author(s)
Abstract
Background/Purpose: There are scarce reports on the prognostic factors and treatment outcomes of patients with malignant pleural mesothelioma (MPM) in Asia. This study aimed to address these matters in a real-world setting. Methods: Medical records of patients with histologically proven MPM diagnosed between 1977 and 2016 at the National Taiwan University Hospital were reviewed. Variables including age, gender, performance status, asbestos exposure, smoking history, histology subtype, staging, and treatment received were recorded. All patients were followed until death or March 1st, 2017. Survival and prognostic factors were analyzed by the Kaplan-Meir method and the Cox proportional hazard model. Results: A total of 93 patients was identified, including 65 men and 28 women. An increasing trend of MPM cases diagnosed was observed in the past 40 years. Stage I/II disease (HR 0.24, 95% CI 0.13–0.46) and epithelioid histology (HR 0.42, 95% CI 0.23–0.75) were associated with favorable prognosis, whereas age ?70 years (HR 2.66, 95% CI 1.36–5.22) and ECOG ?2 (HR 5.03, 95% CI 2.69–9.4) were poor prognostic factors. After adjustment for prognostic factors, surgery in stage I-III MPM (HR 0.36, 95% CI 0.15–0.83) and systemic therapy in stage III/IV disease (HR 0.42, 95% CI 0.19–0.94) conferred a survival benefit. Conclusion: This is one of the largest case series of MPM reported in Asia outside of Japan. Prognostic factors in the study population included age, performance status, stage, and histology subtype. Surgery in potentially resectable disease and systemic therapy in advanced MPM confer a survival benefit in Asian patients. ? 2018
SDGs
Other Subjects
adult; aged; Article; cancer patient; cancer prognosis; cancer staging; cancer survival; disease association; East Asian; electrocorticography; environmental exposure; female; follow up; human; Japan; lung resection; major clinical study; male; medical history; medical record; overall survival; pleura mesothelioma; pleurectomy; population; progression free survival; proportional hazards model; smoking; systemic therapy; Taiwanese; treatment outcome; university hospital; epidemiology; factual database; lung tumor; mesothelioma; middle aged; mortality; pleura tumor; prognosis; survival analysis; Taiwan; Aged; Databases, Factual; Female; Hospitals, University; Humans; Lung Neoplasms; Male; Mesothelioma; Middle Aged; Neoplasm Staging; Pleural Neoplasms; Prognosis; Survival Analysis; Taiwan
Publisher
Elsevier B.V.
Type
journal article