Quoted from http://erj.ersjournals.com/content/early/2011/12/01/09031936.00153611.abstract?maxtoshow=&HITS=10&hits=5&RESULTFORMAT=&andorexacttitleabs=and&fulltext=mesothelioma&andorexactfulltext=and&searchid=1&usestrictdates=yes&resourcetype=HWCIT&ct

Population-based survival for malignant mesothelioma after introduction of novel chemotherapy

Abstract

Malignant mesothelioma is known for its dismal prognosis and poor response to conventional treatment. Chemotherapy with cisplatin-antifolate combinations recently showed promising response rates and prolonged survival in randomised trials.

To assess the impact of this development on clinical practice and survival at a population-based level, treatment patterns and survival trends were studied for patients diagnosed with mesothelioma in the period 1995–2006. 4731 records were retrieved from the Netherlands Cancer Registry and chemotherapy use and median survival were analysed.

For the periods 1995–1998 to 2005–2006, chemotherapy use increased from 8% to 36%. Median survival increased over time from 7.1 months to 9.2 months. For pleural mesothelioma, multivariable analysis demonstrated that survival was poorer for elderly patients and sarcomatoid tumours. The prognostic impact of chemotherapy increased with time. Median survival for chemotherapy treated patients improved from 10.1 months (1995–1998) to 13.1 months (2005–2006). For peritoneal mesothelioma, median survival was poor (3.9 months) but better for females and younger patients.

This study demonstrates that chemotherapy use increased at a national level and coincided with an improvement in survival. The novel chemotherapy regimen appears to be more effective but, due to the observational nature of this study, alternative explanations cannot be excluded.

Quoted from http://erj.ersjournals.com/content/38/6/1420.abstract

Predicting survival in malignant mesothelioma

Abstract

Malignant mesothelioma (MM) of the pleura or peritoneum is a universally fatal disease attracting an increasing range of medical interventions and escalating healthcare costs.

Changes in survival and the factors affecting survival of all patients ever diagnosed with MM in Western Australia over the past five decades and confirmed by the Western Australian Mesothelioma Registry to December 2005 were examined. Sex, age, date and method of diagnosis, site of disease and histological type were recorded. Date of onset of symptoms and performance status were obtained from clinical notes for a sample of cases. Cox regression was used to examine the association of the clinical variables and the 10-yr periods of disease onset with survival after diagnosis.

Survival was inversely related to age, being worse for males (hazard ratio (HR) 1.4, 95% CI 1.2–1.6), and those with peritoneal mesothelioma (HR 1.4, 95% CI 1.1–1.7). Patients with sarcomatoid histology had worse prognosis than patients with epithelioid and biphasic histological subtypes. Survival improved after the 1970s and has made incremental improvements since then. Median (interquartile range) survival by decade, from 1960 until 2005, was 64 (0–198), 177 (48–350), 221 (97–504), 238 (108–502) and 301 (134–611) days; ?4 weeks of this apparent improvement can be attributed to earlier diagnosis.

With increasing resources and treatment costs for MM over the past 40 yrs, there have been modest improvements in survival but no complete remissions.