Clinical Features in Patients With Malignant Pleural Mesothelioma With 5-Year Survival and Evaluation of Original Diagnoses
Autor: | Jari Räsänen, Sanna Laaksonen, Eeva Kettunen, Tapio Vehmas, Marjukka Myllärniemi, Juuso Paajanen, Jarmo A. Salo, Eva Sutinen, Ilkka Ilonen, Henrik Wolff, Mikko I. Mäyränpää |
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Přispěvatelé: | HUS Heart and Lung Center, Keuhkosairauksien yksikkö, Helsinki University Hospital Area, INDIVIDRUG - Individualized Drug Therapy, Research Programs Unit, Faculty of Medicine, University of Helsinki, Department of Pathology, HUSLAB, Department of Surgery, Clinicum, III kirurgian klinikka, Department of Medicine, University Management |
Rok vydání: | 2020 |
Předmět: |
Male
0301 basic medicine Oncology Cancer Research Multivariate analysis SURGERY medicine.medical_treatment medicine.disease_cause PROGNOSTIC-FACTORS 0302 clinical medicine HISTORY Medicine Registries Medical diagnosis Diagnostic assessment Survival time Medical record Long-term survivors Middle Aged Prognosis Combined Modality Therapy 3. Good health Survival Rate 030220 oncology & carcinogenesis Female Pulmonary and Respiratory Medicine medicine.medical_specialty Pleural Neoplasms BIOMARKERS 3122 Cancers Clinical factors Prognostic factors Malignancy Asbestos 03 medical and health sciences FUTURE Internal medicine SCORE Humans Lung cancer Aged Retrospective Studies Chemotherapy Performance status business.industry Mesothelioma Malignant LONG-TERM SURVIVAL 3126 Surgery anesthesiology intensive care radiology medicine.disease 030104 developmental biology Case-Control Studies 3121 General medicine internal medicine and other clinical medicine business Follow-Up Studies |
Zdroj: | Clinical Lung Cancer. 21:e633-e639 |
ISSN: | 1525-7304 |
Popis: | Within a larger national malignant pleural mesothelioma cohort, we identified 43 patients with unusually long survival times. This study aimed to evaluate the diagnostic accuracy in this subgroup, and the diagnosis was confirmed to be correct in most cases. In addition, we searched for clinical factors related to the prolonged survival time. Introduction: Malignant pleural mesothelioma (MPM) is a fatal malignancy strongly associated with previous asbestos exposure. Overall survival remains dismal, partly owing to poor response to available treatment. The aims of this study were to evaluate diagnostic accuracy in a group of patients with MPM with an unusually long survival time and to assess the factors related to this prolonged survival. Materials and Methods: Forty-three patients with overall survival exceeding 5 years were accepted to the long-term survivor (LTS) group, and these patients were compared with 84 patients with epithelial MPM. Data were collected from various national registries and electronic medical records. In addition, all available histopathologic diagnostic samples and computed tomography studies were re-evaluated by experienced specialists. Results: Our study showed a good diagnostic accuracy, with only 1 (0.5%) patient having an incorrect MPM diagnosis. Two (0.9%) localized malignant mesotheliomas and 2 (0.9%) well-differentiated papillary mesotheliomas were also found. LTS patients were younger, more frequently female, had a better performance status at time of diagnosis, and had less evidence of prior asbestos exposure. In multivariate analysis, we showed tumor size, Eastern Cooperative Oncology Group performance status, and first-line treatment (both surgery and chemotherapy) to be associated with survival time. Conclusion: We confirmed the diagnosis of MPM in an overwhelming majority of patients in the LTS group. An epithelial subtype of MPM behaving clinically more indolently seems to exist, but further tumor and genetic characterization is needed. The prolonged survival time is most likely explained by a combination of tumor-, patient-, and treatment-related factors. (C) 2020 Elsevier Inc. All rights reserved. |
Databáze: | OpenAIRE |
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