Prognostic factors influencing survival in 35 patients with malignant peritoneal mesothelioma

Our plain-English summary of Prognostic factors influencing survival in 35 patients with malignant peritoneal mesothelioma, by H. Kaya, C. Sezgı, A.C. Tanrıkulu, et al (Neoplasma, 2014).

The study

• Authors: H. Kaya, C. Sezgı, A.C. Tanrıkulu, M. Taylan, O. Abakay, H.S. Sen, A. Abakay, M. Kucukoner, M. Kapan
• Journal: Neoplasma
• Published: 2014;61(4):433-8
• Cited by: 46 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Malignant mesothelioma is a rare but highly lethal form of cancer that affects the serosal membranes. Malignant peritoneal mesothelioma (MPM) is the second most common form of malignant mesothelioma (pleural mesothelioma is the most common). The aim of this study was to evaluate prognostic factors influencing the survival of patients with MPM. A retrospective analysis was performed on 35 patients who were admitted to our hospital between March 2005 and July 2013. The patients' demographic and clinical data, laboratory results, radiological signs, Eastern Cooperative Oncology Group (ECOG) performance status (PS), and treatment outcomes were evaluated. The mean age of the 35 patients was 59.0±14.4 years, the mean survival time was 16.2±12.9 months, and the majority of the histopathological types of MPM were epithelial (68.6%). 82.9% of the patients had been exposed to asbestos, and the mean duration of exposure was 28.3±14.5 years. The most frequent symptoms were abdominal distention/pain, weight loss, dyspnea, and chest pain. The mean interval between the onset of symptoms and the diagnosis was 4.6±3.3 months. Platinum-based combination chemotherapy in combination with supportive care was used in the treatment of 68.6% of the patients, while supportive treatment alone was used in the others. Our results revealed that patients who were >60 years old (p=0.019), who were exposed to asbestos >20 years (p=0.033), who had an ECOG PS of 3 (p=0.000) were more likely to have a poor MPM prognosis.In conclusion, increased age, duration of environmental asbestos exposure and ECOG PS are important factors that influence the prognosis of MPM patients.

In plain English

This was a retrospective review of 35 patients with malignant peritoneal mesothelioma, a cancer of the lining of the abdomen. They were admitted to a hospital at Dicle University in Diyarbakir, Turkey, between March 2005 and July 2013. The authors examined which features at diagnosis were linked to survival. Of the 35 patients, 29 (82.9%) had environmental asbestos exposure, lasting 28.3 years on average. The article does not say which fiber type these patients were exposed to. Mean survival was 16.2 months, and 32 patients died during follow-up. Median survival was 10.3 months for patients over 60 versus 19.6 months for those 60 or younger. It was 12.1 months for those exposed more than 20 years versus 24.3 months for 20 years or less. Patients with performance status 3 (in bed more than half the day) survived a median 5.5 months, against 17.6 and 19.5 months for scores 1 and 2. Sex, tumor type, chemotherapy and blood tests showed no statistically significant link with survival. The authors concluded that age, exposure duration and performance status were associated with prognosis.

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 analysis of hospital patients (case series with survival analysis using the Kaplan-Meier method and stratified log-rank test)
• Who was studied: 35 patients with malignant peritoneal mesothelioma admitted to the authors' hospital (Dicle University, Diyarbakir, Turkey) between March 2005 and July 2013. There were 19 women and 16 men, with a mean age of 59.0 years (range 36 to 92).
• Exposure: Environmental asbestos exposure, recorded as yes or no and by duration (20 years or less vs more than 20 years). Mean duration was 28.3 years (range 5 to 70). The fiber type to which these patients were exposed is not specified.
• Main results:
  • 29 of the 35 patients (82.9%) had been exposed to asbestos
  • Mean survival for all 35 patients was 16.2 months (plus or minus 12.9; range 3 to 52). 32 patients died during follow-up.
  • Patients older than 60 had shorter survival: median 10.3 months vs 19.6 months for those aged 60 or younger (p=0.019)
  • Patients exposed to asbestos for more than 20 years had shorter survival: median 12.1 months vs 24.3 months for 20 years or less (p=0.033)
  • By ECOG performance status at diagnosis, median survival was 17.6 months (score 1), 19.5 months (score 2) and 5.5 months (score 3). Table 3 gives p less than 0.001; the text reports p=0.000.
  • Sex and histopathological type (epithelial vs others) were not significantly related to survival. Patients given chemotherapy had a median survival of 19 months vs 8.4 months without it, but this difference was not significant when age was included as a confounding factor.
  • Pretreatment blood test levels (hemoglobin, white cells, platelets, albumin, LDH, ALP, CRP, ESR) showed no significant relationship with survival
  • On imaging, pleural calcification/plaques were seen in 18 of 35 patients (51.4%; 13 unknown) and pleural thickening in 7 (20.0%)
• The authors' conclusion: The authors concluded that age, duration of asbestos exposure and ECOG performance status were associated with the prognosis of malignant peritoneal mesothelioma, and called for prospective studies.
• Limitations the authors state:
  • The study was retrospective. Imaging results could not be found in some files for patients referred from other centers.
  • The authors suggested the lack of significant laboratory findings may reflect the small number of patients

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma, Peritoneal mesothelioma.

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Malignant Mesothelioma, Pleural Mesothelioma, Performance Status, Dyspnea, Chemotherapy, Prognosis, Asbestos Exposure.

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