Clinical characteristics and treatment outcomes in 132 patients with malignant mesothelioma

Our plain-English summary of Clinical characteristics and treatment outcomes in 132 patients with malignant mesothelioma, by A. Abakay, A.C. Tanrikulu, M.A. Kaplan, et al (Lung India, 2011).

The study

• Authors: A. Abakay, A.C. Tanrikulu, M.A. Kaplan, M. Kucukoner, O. Abakay, H. Sen, A. Isikdogan, A. Senyigit
• Journal: Lung India
• Published: 2011;28(4):267-71
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Purpose: Our objective is to scrutinize clinical, laboratory, radiological characteristics, treatment regimens, and treatment outcomes of malignant mesothelioma (MM) cases in our hospital.

Materials And Methods: We investigated, retrospectively, the clinical characteristics and treatment outcomes of all 132 MM patients at Dicle University Hospital between January 2006 and April 2010.

Results: A total of 82 (62.1%) patients were male, and 50 (37.9%) female. Median age was 56.0 years. Mean survival time was 9.6±6.9 months. Mean survival time of patients who had received best supportive care was 7.5 months, chemotherapy 10.4 months, and multimodality treatment regimen 12.6 months. Patients in the multimodality treatment group survived longer than did those in the other two groups (P=0.042). A total of 76 patients received chemotherapy, of whom 17 (22.3%) were administered Cisplatin/Carboplatin and Gemcitabine, 58 (76.4%) Cisplatin/Carboplatin and Pemetrexed, and one (1.3%) Cisplatin + Docetaxel. Complete and partial response to treatment in patients receiving Cisplatin/Carboplatin and Gemcitabine was found 47.1% and Cisplatin/Carboplatin and Pemetrexed was found 50.0% (P>0.05).

Conclusions: MM related to asbestos exposure is seen frequently in Turkey. Patients present with the typical clinical features of dyspnea, weight loss, and chest pain. Survival analysis shows that patients receiving multimodality treatment may be better.

In plain English

This retrospective study reviewed records of all 132 patients with tissue-confirmed malignant mesothelioma seen at Dicle University Hospital, Diyarbakir, Turkey, January 2006 to April 2010. The authors described the region as having intensive environmental asbestos exposure. Patients were 82 men and 50 women, median age 56.0 years. Environmental asbestos exposure was found in 76.5%; mean time from first exposure to diagnosis was 45.5 years. Disease began in the pleura in 119 and the peritoneum in 12. The commonest symptoms were shortness of breath, weight loss and chest pain. Mean survival was 9.6 months overall (95% confidence interval 8.28 to 10.99). It was 7.5 months (6.03 to 9.47) with best supportive care, 10.4 months (8.42 to 12.38) with chemotherapy, and 12.6 months (7.60 to 17.78) with multimodality treatment. The multimodality group's longer survival was reported as significant (P=0.042). Complete or partial response occurred in 8 of 17 patients (47.1%) given platinum plus gemcitabine and 29 of 58 (50.0%) given platinum plus pemetrexed, not a significant difference. The authors concluded multimodality treatment may give better survival, cautioning that response data from few chemotherapy patients may be unreliable.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Retrospective review of hospital patient files (case series)
• Who was studied: 132 patients with histopathologically diagnosed malignant mesothelioma, seen January 2006 to April 2010 at the Chest Diseases and Medical Oncology Departments of Dicle University in Diyarbakir, Turkey. There were 82 men and 50 women, with a median age of 56.0 years. The primary site was the pleura in 119 (90.2%), the peritoneum in 12 (9.1%) and the pericardium in 1 (0.7%).
• Exposure: Environmental asbestos exposure in the Southeast Anatolia region; no fiber type is specified for the patients. Exposure was found in 76.5% of patients. The mean exposure duration was 33.2 years (range 0 to 63), and the mean latent period was 45.5 years (range 25 to 85). The treatments compared were best supportive care, chemotherapy, and multimodality treatment (adjuvant chemoradiotherapy after extrapleural pneumonectomy).
• Main results:
  • For all patients, mean survival was 9.6 months (range 1 to 41; 95% CI 8.28 to 10.99 in Table 2). Survival was significantly longer in the multimodality treatment group than in the other groups (P=0.042). 93 of the 132 patients (70.4%) died during the study.
  • Mean survival by treatment group (Table 2):
• Best supportive care: 7.5 months (95% CI 6.03 to 9.47), 56 patients.
• Chemotherapy: 10.4 months (95% CI 8.42 to 12.38), 61 patients.
• Multimodality treatment: 12.6 months (95% CI 7.60 to 17.78), 15 patients.
  • Among the 76 patients who received chemotherapy, the combined complete plus partial response rate differed by regimen. The difference was not statistically significant (P>0.05).
• Cisplatin or carboplatin with gemcitabine: 47.1% (2 complete plus 6 partial responses, 8 of 17 patients).
• Cisplatin or carboplatin with pemetrexed: 50.0% (6 complete plus 23 partial responses, 29 of 58 patients).
  • At diagnosis, the main symptoms were:
• dyspnea: 101 patients (76.5%)
• weight loss: 98 (74.2%)
• chest pain: 91 (68.9%)
  • Symptom duration before diagnosis was significantly longer for the epithelial subtype than for non-epithelial subtypes (P=0.013):
• epithelial subtype: 7.5 months
• non-epithelial subtypes: 4.8 months
• The authors' conclusion: The authors concluded:
• Asbestos-related malignant mesothelioma is seen frequently in Turkey.
• Patients present with dyspnea, weight loss and chest pain.
• Survival analysis suggests that patients receiving multimodality treatment may do better.

In the discussion, they suggested multimodality treatment might be useful in early-stage cases.

• Limitations the authors state:
  • Only a limited number of patients received chemotherapy, so the authors stated that the reliability of the treatment response data may be low. They suggested evaluation in a larger series.

Topics

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Chemotherapy, Cisplatin, Carboplatin, Gemcitabine, Pemetrexed (Alimta), Asbestos Exposure, Dyspnea.

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