Prognosis and prognostic factors of patients with mesothelioma: 15% 3-year survival is surprising, suggests some misdiagnoses

http://www.ncbi.nlm.nih.gov/pubmed/22644294

Br J Cancer. 2012 May 29. doi: 10.1038/bjc.2012.245. [Epub ahead of print]

Prognosis and prognostic factors of patients with mesothelioma: a population-based study.

van der Bij S, Koffijberg H, Burgers JA, Baas P, van de Vijver MJ, de Mol BA, Moons KG.

Source

Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, P.O. Box 85500, GA Utrecht 3508, The Netherlands.

Abstract

Background:

It is important to regularly update survival estimates of patients with malignant mesothelioma as prognosis may vary according to epidemiologic factors and diagnostic and therapeutic management.

Methods:

We assessed overall (baseline) survival as well as related prognostic variables in a large cohort of 1353 patients with a confirmed diagnosis of malignant mesothelioma between 2005 and 2008.

Results:

About 50% of the patients were 70 years or older at diagnosis and the median latency time since start of asbestos exposure was 49 years. One year after diagnosis, 47% of the patients were alive, 20% after 2 years and 15% after 3 years. Prognostic variables independently associated with worse survival were: older age (HR=1.04 per year 95% CI (1.03-1.06)), sarcomatoid subtype (HR=2.45 95% CI (2.06-2.90)) and non-pleural localisation (HR=1.67 95% CI (1.26-2.22)).

Conclusion:

Survival of patients with malignant mesothelioma is still limited and depends highly on patient age, mesothelioma subtype and localisation. In addition, a substantial part of the patients had a long latency time between asbestos exposure and diagnosis.