Determinants of malignant pleural mesothelioma survival and burden of disease in France: a national cohort analysis

Autor: Alexandre Vainchtock, C. Tournier, Arnaud Scherpereel, Jean Baptiste Assié, Pascal Andujar, Jean Claude Pairon, C. Blein, Isabelle Monnet, Christos Chouaid
Přispěvatelé: IMRB - CEPIA/'Clinical Epidemiology And Ageing : Geriatrics, Primary Care and Public Health' [Créteil] (U955 Inserm - UPEC), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service de Pneumologie [CHI Créteil], CHI Créteil, Service de Pneumologie et de Pathologie Professionnelle [CHI Créteil], HEVA Lyon, Centre d’Infection et d’Immunité de Lille - INSERM U 1019 - UMR 9017 - UMR 8204 (CIIL), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre National de la Recherche Scientifique (CNRS), CHU Lille
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Adult
Mesothelioma
Cancer Research
medicine.medical_specialty
Multivariate analysis
Lung Neoplasms
Bevacizumab
Databases
Factual
Pleural Neoplasms
[SDV.CAN]Life Sciences [q-bio]/Cancer
Comorbidity
outcomes
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Cost of Illness
Internal medicine
medicine
Humans
Radiology
Nuclear Medicine and imaging
Public Health Surveillance
030212 general & internal medicine
Socioeconomic status
Original Research
Aged
Aged
80 and over
Proportional hazards model
business.industry
Mesothelioma
Malignant
Clinical Cancer Research
Health Care Costs
Middle Aged
medicine.disease
Costs
social deprivation
Pemetrexed
Social deprivation
Oncology
030220 oncology & carcinogenesis
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
France
Rural area
business
management
medicine.drug
Zdroj: Cancer Medicine
Cancer Medicine, 2018, 7 (4), pp.1102-1109. ⟨10.1002/cam4.1378⟩
ISSN: 2045-7634
DOI: 10.1002/cam4.1378⟩
Popis: International audience; This study was undertaken to determine the healthcare burden of malignant pleural mesothelioma (MPM) in France and to analyze its associations with socioeconomic deprivation, population density, and management outcomes. A national hospital database was used to extract incident MPM patients in years 2011 and 2012. Cox models were used to analyze 1- and 2-year survival according to sex, age, co-morbidities, management, population-density index, and social deprivation index. The analysis included 1,890 patients (76% men; age: 73.6 ± 10.0 years; 84% with significant co-morbidities; 57% living in urban zones; 53% in highly underprivileged areas). Only 1% underwent curative surgical procedure; 65% received at least one chemotherapy cycle, 72% of them with at least one pemetrexed and/or bevacizumab administration. One- and 2-year survival rates were 64% and 48%, respectively. Median survival was 14.9 (95% CI: 13.7-15.7) months. The mean cost per patient was 27,624 ± 17,263 euros (31% representing pemetrexed and bevacizumab costs). Multivariate analyses retained men, age >70 years, chronic renal failure, chronic respiratory failure, and never receiving pemetrexed as factors of poor prognosis. After adjusting the analysis to age, sex, and co-morbidities, living in rural/semi-rural area was associated with better 2-year survival (HR: 0.83 [95% CI: 0.73-0.94]; P < 0.01); social deprivation index was not significantly associated with survival. With approximately 1,000 new cases per year in France, MPMs represents a significant national health care burden. Co-morbidities, sex, age, and living place appear to be significant factors of prognosis.
Databáze: OpenAIRE
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