Multicentric study on malignant pleural mesothelioma in Turkey: clinicopathologic and survival characteristics of 282 patients

Our plain-English summary of Multicentric study on malignant pleural mesothelioma in Turkey: clinicopathologic and survival characteristics of 282 patients, by E.T. Elkiran, M.A. Kaplan, A. Sevinc, et al (Medical Oncology, 2012).

The study

• Authors: E.T. Elkiran, M.A. Kaplan, A. Sevinc, S. Aksoy, U. Demirci, M. Seker, H. Harputluoglu, N.Y. Ozdemir, F. Isik, A. Ulas, M. Inanc, U.Y. Arslan, G.G. Dogu, A. Isikdogan, S. Buyukberber, Anatolian Society of Medical Oncology Group
• Journal: Medical Oncology
• Published: 2012;29(5):3147-54
• Cited by: 8 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Malignant pleural mesothelioma (MPM) is a relatively rare, but aggressive tumor that causes high mortality. The major risk factor involved in the etiology is environmental and occupational exposure to asbestos. The optimal modality of therapy is controversial. The present study retrospectively evaluated the data pertinent to 282 patients who were examined and treated in 11 different medical oncology centers in Turkey. There were 161 males (57.1 %) and 121 females (42.9 %), with a mean age of 56.38 ± 12.07 years. Surgery was used in 74 patients, 21 patients (28.4 %) received only chemotherapy and 28 patients (37.8 %) received chemoradiotherapy after surgery. The median survival in patients who were administered adjuvant therapy after surgery was 24 months, while the median survival in patients who had only surgery was 6 months (p = 0.029). 106 patients were administered pemetrexed-platinum combination and 35 patients were administered gemcitabine-platinum combination as front-line chemotherapy. Median survival, 1- and 2-year survival rates in patients who received platinum analogues and pemetrexed or gemcitabine combinations were found statistically similar (p = 0.15). The median survival for all patients with MPM in our study was 18 months. The main factors influencing the overall survival were stage of the disease (p = 0.020), performance status (p < 0.001), asbestos exposure (p = 0.030) and mesothelioma histological subtypes (p < 0.001). Results of our study suggest that multi-modality treatment regimens consisting of surgery, radiotherapy and chemotherapy prolong overall survival. Survival rates in patients who received combining platinum analogues with pemetrexed or gemcitabine as front-line chemotherapy were found similar.

In plain English

This retrospective study reviewed the records of 282 patients with malignant pleural mesothelioma treated at 11 medical oncology centers in Turkey from July 2000 to February 2011. Environmental asbestos exposure was recorded in 138 patients and erionite exposure in 11. Thirty-seven patients had no asbestos exposure, and 107 were not asked about it. The authors reported that none of the patients had occupational asbestos exposure. Median survival for all patients was 18 months, and the 5-year survival rate was 13 %. Patients who received further treatment after surgery had a median survival of 24 months, compared with 6 months for those who had surgery only. Survival did not differ significantly (p = 0.15) between front-line pemetrexed-platinum (16 months, 106 patients) and gemcitabine-platinum (26 months, 35 patients). Stage, performance status, histological subtype and asbestos exposure were associated with survival. Patients with asbestos exposure had better survival than those without (p = 0.030). The authors concluded that combined treatment with surgery, radiotherapy and chemotherapy prolongs overall survival. The article has some internal inconsistencies in its tables and figure references.

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 multicenter review of patient records
• Who was studied: 282 patients with malignant pleural mesothelioma (161 males, 121 females, mean age 56.38 years) treated at 11 medical oncology centers in Turkey, July 2000 to February 2011
• Exposure: Environmental (non-occupational) exposure to asbestos starting in childhood, in regions of Eastern, South Eastern and Central Anatolia with natural asbestos and erionite deposits. Erionite exposure occurred in 11 patients from Nevsehir. No fiber type is named for the patients.
• Main results:
  • Asbestos exposure was absent in 37 patients and was not asked about in 107 patients
  • The authors reported no occupational asbestos exposure among the patients
  • All 282 patients: median survival 18 months; 1-, 3- and 5-year survival rates of 69, 28 and 13 %
  • Patients given adjuvant therapy after surgery had a median survival of 24 months, compared with 6 months for patients who had surgery only (p = 0.029)
  • There was no statistical difference in median overall survival between patients who had surgery and those who did not (p = 0.85)
  • For front-line chemotherapy, median survival was 26 months with gemcitabine-platinum (n = 35) and 16 months with pemetrexed-platinum (n = 106). The difference was not statistically significant (p = 0.15).
  • The 1- and 2-year survival rates were 90 and 57 % with gemcitabine-platinum and 59 and 36 % with pemetrexed-platinum. The authors reported no statistical difference.
  • Factors that affected overall survival were stage (p = 0.020), performance status (p less than 0.001), histological subtype (epithelial better than sarcomatoid, p less than 0.001) and asbestos exposure (p = 0.030)
  • Presence of asbestos exposure was associated with better survival than absence of exposure
• The authors' conclusion: The authors concluded that multi-modality treatment consisting of surgery, radiotherapy and chemotherapy prolongs overall survival. They also concluded that survival was similar with platinum plus pemetrexed or gemcitabine as front-line chemotherapy.
• Limitations the authors state:
  • Because the study was retrospective, not all toxicity data, especially on low-grade toxicity, may have been captured

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Etiology, Occupational Exposure, Chemotherapy, Median Survival, Adjuvant Therapy, Pemetrexed (Alimta), Gemcitabine.

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