Characteristics of long-term survivors with malignant pleural mesothelioma
The Annals of Thoracic Surgery 2024 October 22 [Link]
Isabelle Opitz, Olivia Lauk, Raphael Werner, Alessandra Matter, Monika Hebeisen, Bianca Battilana, Hasan Batirel, Harvey Pass, Raja Flores, Andrea Wolf, Marc de Perrot, Mir Alireza Hoda, Walter Klepetko, Thomas Klikovits, Masaki Hashimoto, Seiki Hasegawa, William G Richards, Raphael Bueno
Abstract
Background: Pleural mesothelioma (PM) is a cancer with usually a dismal prognosis. However, long-term survivors do exist. Herein, we analyzed long-term survivors (>5 years after surgery) from high-volume centres around the world.
Methods: This is a multicenter retrospective descriptive analysis of long-term survivors (overall survival ≥ 5 years from surgery) treated within a multimodality therapy approach including macroscopic complete resection. Overall survival was calculated with Kaplan Meier analysis and cases were matched by center and surgery year and compared with a control group of short-term survivors (<2 years) in a conditional logistic regression analysis.
Results: There were 276 long-term survivors, most were male (n=166, 63%) with a median age of 59 (range 21-83) years at time of diagnosis. The histology for 246 was epithelioid and non-epithelioid for 30 patients. The disease was on the right side in 58% of the patients. As of this analysis, 148 patients were dead, 104 were alive and 10 were lost to follow-up. Pathological tumor stages were: pT1 (n=50), pT2 (n=63), pT3 (n=90) or pT4 (n=16), pN0 (n=150), pN1 (n=20) and pN2 (n=39). The matched control dataset included 333 patients, 95 cases and 238 controls. Comparing short- with long-term survivors, there was moderate evidence that a low white blood cell (WBC) count before surgery was more often observed in long-term survivors.
Conclusions: The data show that long-term survival in PM is possible in a subgroup of surgically treated patients; histological subtype and WBC count seem to be prognosticators for longer survival.