Survival after conservative (palliative) management of pleural malignant mesothelioma

Background and Objectives Malignant mesothelioma is a lethal disease. Aggressive multimodality treatment protocols are reportedly associated with improved survival, but the apparent survival benefits may simply reflect patient selection and the variable natural history of this malignancy. Before emb...

Full description

Saved in:
Bibliographic Details
Published in:Journal of surgical oncology 2001-11, Vol.78 (3), p.171-174
Main Authors: Merritt, Neil, Blewett, Christopher J., Miller, John D., Bennett, W. Frederick, Young, J. Edward M., Urschel, John D.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Female
Humans
Male
Medical sciences
mesothelioma
Mesothelioma - mortality
Mesothelioma - therapy
Middle Aged
natural history
Palliative Care
pleural neoplasms
Pleural Neoplasms - mortality
Pleural Neoplasms - therapy
Pneumology
prognosis
Retrospective Studies
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the respiratory system
Survival Analysis
Tumors of the respiratory system and mediastinum
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background and Objectives Malignant mesothelioma is a lethal disease. Aggressive multimodality treatment protocols are reportedly associated with improved survival, but the apparent survival benefits may simply reflect patient selection and the variable natural history of this malignancy. Before embarking on our own protocol of experimental treatment for mesothelioma, we sought to identify important prognostic factors and document the survival of patients treated conservatively (with palliative intent only) in our region. Methods We performed a retrospective review of all patients with a diagnosis of malignant mesothelioma seen at our center between 1987 and 1999. Since curative intent treatment had not been given, we assumed that measured survival would largely reflect the natural history of the malignancy. Results There were 101 patients (80 males and 21 females). Mean age was 65 ± 9.2 years. Symptoms of disease were present for a median time of 5 months before the diagnosis was established. The most common presenting symptoms were dyspnea (46 patients), chest pain (30 patients), and weight loss (22 patients). Sixty‐eight patients (68%) had a history of asbestos exposure. Mesothelioma subtypes included epithelial (43 patients), sarcomatous (26 patients), mixed (19 patients), desmoplastic (4 patients), and unspecified (9 patients). All 101 patients were treated with palliative intent. Talc pleurodesis was performed in 70 patients. At the time of analysis, 90 patients had died and 11 remained alive. Median survival was 213 (95% CI 137–289) days. Survival for the three major histological subtypes was significantly different (log rank, P = 0.0016). Histological subtype (epithelial favorable) was the only significant independent prognostic factor (Cox proportional hazard regression, P = 0.0009). Conclusions Patients with epithelial mesothelioma survive longer than those with other histological subtypes. Conservatively managed patients with pleural malignant mesothelioma have a median survival of approximately 7 months. These data from conservatively treated patients can serve as baseline information for future studies of experimental treatments. J. Surg. Oncol. 2001;78:171–174. © 2001 Wiley‐Liss, Inc.
ISSN:0022-4790
1096-9098
DOI:10.1002/jso.1143