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Patterns of care for malignant pleural mesothelioma patients compensated by the D ust D iseases B oard in N ew S outh W ales, A ustralia
Author(s) -
Kao S. C.H.,
Clarke S.,
Vardy J.,
Corte P.,
Clarke C.,
Zandwijk N.
Publication year - 2013
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/j.1445-5994.2012.02925.x
Subject(s) - medicine , extrapleural pneumonectomy , mesothelioma , radiation therapy , palliative care , chemotherapy , surgery , radiology , lung cancer , pneumonectomy , pathology , nursing
Background The silent epidemic of mesothelioma in A ustralia is steadily increasing, and 30% of cases occur in New South Wales ( NSW ). Aim To describe the patterns of care and outcomes of patients with malignant pleural mesothelioma ( MPM ) in NSW . Methods MPM patients in NSW applying for compensation at the NSW D ust D iseases B oard from 2007 to 2009 were included. Survival from time of diagnosis was determined by the K aplan– M eier method. The Chi‐squared test was used to determine if there was an association between utilisation of treatment and geographical location. Results A total of 138 patients was included: median age was 72.5; 91.3% male; 60.1% epithelial subtype; and 65.2% lived in major cities. All patients had at least one chest X ‐ray and computed tomography scan, and 21% had a positron emission tomography scan; 93.5% and 4.3% had histological or cytological confirmation respectively. Thoracoscopy (59.4%) was the most commonly used diagnostic procedure. Treatment utilisation: 53.6% chemotherapy; 35.5% radiotherapy; 9.4% extrapleural pneumonectomy ( EPP ); and 72.5% had palliative care involvement. There were no major differences in treatment utilisation between patients living in major cities and those in regional NSW (chemotherapy P = 0.42; radiotherapy P = 0.13 and palliative care P = 0.60), except for a higher rate of EPP in regional patients (16.7% vs 5.6%; P = 0.03). Median survival was 9.7 versus 12.3 months for city and regional patients respectively ( P = 0.22). Conclusion Survival and treatment utilisation was not significantly different between MPM patients living in major cities and regional NSW , except for a higher rate of EPP in patients in regional NSW .