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Survival of pleural malignant mesothelioma in Italy: A population‐based study
Author(s) -
Montanaro Fabio,
Rosato Rosalba,
Gangemi Manuela,
Roberti Sara,
Ricceri Fulvio,
Merler Enzo,
Gennaro Valerio,
Romanelli Antonio,
Chellini Elisabetta,
Pascucci Cristiana,
Musti Marina,
Nicita Carmela,
Barbieri Pietro Gino,
Marinaccio Alessandro,
Magnani Corrado,
Mirabelli Dario
Publication year - 2008
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.23874
Subject(s) - mesothelioma , medicine , hazard ratio , proportional hazards model , population , cancer registry , asbestos , pleural disease , survival analysis , confidence interval , oncology , surgery , epidemiology , pathology , respiratory disease , lung , materials science , environmental health , metallurgy
A median survival time of about 9 months is generally reported among malignant pleural mesothelioma cases. Recently, better results in terms of survival and performance status have been reported in clinical trials that included highly selected patients. We describe the survival of pleural mesothelioma patients and the factors predictive of survival in an unselected, population‐based setting. Pleural mesothelioma cases (4,100) registered from 1990 to 2001 by 9 Italian regional mesothelioma registries contributing to the network of the National Mesothelioma Registry were followed until December 31, 2005. Univariate (Kaplan‐Meier) and multivariate (Cox proportional hazards regression) analyses of survival were carried out according to selected individual characteristics, including limited information on treatment in a subset of 578 cases. The median survival time was 9.8 months (95% confidence interval: 9.4–10.1). In multivariate analysis, younger age at diagnosis and epithelioid histotype were associated with significantly reduced hazard ratios. Positive effects of gender (women) and being diagnosed in a hospital with a thoracic surgery unit were of border‐line statistical significance. No association with calendar period of diagnosis or asbestos exposure was present. Treatment was not associated with a statistically significant improvement in survival. This is the largest population‐based study on survival in patients with pleural mesothelioma to date. Age and morphology were the main prognostic factors. Results regarding the effect of treatment were disappointing but may be useful to assess the future impact, at the population level, of recently introduced therapies. © 2008 Wiley‐Liss, Inc.