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
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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