September 03, 2015
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Model helps predict long-term survival after surgery in patients with malignant mesothelioma

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A prognostic model appeared to help predict long-term survival in patients with malignant pleural mesothelioma who underwent extrapleural pneumonectomy, according to results of a retrospective study.

“The therapy for malignant pleural mesothelioma is still somewhat controversial, and the optimal surgical approach is still a matter of debate,” Giovanni Leuzzi, MD, medical director of thoracic surgery at IRCCS Foundation, National Cancer Institute in Milan, said in a press release. “Our study found clinic-surgical factors that can indicate which patients will benefit the most from surgery so that patients and their physicians can better decide the optimal course of therapy.”

Leuzzi and colleagues retrospectively reviewed clinicopathologic and oncological factors of patients with malignant pleural mesothelioma (MPM) who had undergone extrapleural pneumonectomy to determine predictors of long-term survival after surgery.

The analysis included 468 patients (median age, 61 years) who underwent surgery for MPM in nine thoracic surgery centers in Italy from January 2000 to December 2010.

Almost one in four (22.9%) patients survived at least 3 years after surgery. Patients who survived at least 3 years had a lower exposure to asbestos (71.6%) compared with those who did not survive as long (83.1%) (P = .03).

Age (OR = 0.51; 95% CI, 0.31-0.82), epithelioid histology (OR = 7.07; 95% CI, 1.56-31.93), no history of asbestos exposure (OR = 3.13; 95% CI, 1.13-8.66) and the ratio between metastatic and resected lymph nodes (OR = 4.12; 95% CI, 1.68-10.12) all independently predicted long-term survival in the patients.

Leuzzi and colleagues proposed a scoring system — taken from the predictive factors — to stratify overall survival, cancer-specific survival and disease-free survival in this group of patients.

“This easy-to-use model could help physicians in stratifying the treatment outcome and, eventually, tailoring postoperative treatment by identifying those patients who require close surveillance or more aggressive cancer therapy,” he said. “Unfortunately, MPM still has poor prognosis, even after surgery.” – by Ryan McDonald

Disclosure: The researchers report no relevant financial disclosures.