No abstract

Background: Mesothelioma is a deadly neoplasia related to asbestos, a mineral extensively used in Spain in the 1970-80s until its ban in 2001. The incidence of mesothelioma in the region of Vallès is 1.73 cases / 100,000 inhabitants / year, five times higher than the national average, due to the industrial activity of the area. This rise is likely to increase in the forthcoming years. Methods: We describe the epidemiological, diagnostic, pathological and therapeutic characteristics and the overall survival of 140 patients with mesothelioma diagnosed between April 1995 and December 2015 at a single center. Results: The median age was 70 years (44-89), 72.9% were males and 60% had been exposed to asbestos. A total of 55.7% were ECOG 0-1. The origin was pleural in 85% and peritoneal in 12.9%. Histology was: epithelioid in 45%, biphasic in 13.6%, sarcomatoid in 12.9% and unknown in 28.5%. All patients were clinically staged, 31.8% were EIII and 31.8% EIV. Pleurodesis was performed in 43.6%. Fifty percent of patients received palliative chemotherapy (66.2% a combination of platinum plus pemetrexed, 12.7% platinum plus gemcitabine). They received a median of 5 cycles (1-9). The response rate was 43.7%, with 26.8% stabilizations. Reasons for treatment discontinuation were: progression in 36.6% and toxicity in 12.7%. At the time of progression ECOG was 0-1 in 57.7%. Second-line treatment was administered in 46.5%. The median overall survival was 7.4 months (95% CI 4.98-9.91), with significant differences depending on the number of lines of treatment received: 0 vs. 1 vs. 2 (3, 8.5, 21.2 months p <0.001). Univariate analysis identified histology (p ¼ 0.033), localization (p <0.001), ECOG (p <0.001), leukocytosis (p ¼ 0.046) and LDH (p <0.001), as potential prognostic factors. Conclusion:The results are consistent with the published literature. We found significant differences in survival according to histology, location, ECOG and other prognostic factors previously explored.

differences according to treatment received (p ¼ 0.064) or PS (p ¼ 0.345). The median overall survival was 9.7 months (95% CI 6.670-12.740). The median time from the last administration of chemotherapy to death was 6.8 months (95% CI 2240-6288). Conclusion: In our experience, second-line chemotherapy in malignant mesothelioma is feasible, with a clinical benefit and a response rate that allows third-line treatment to be administered to a non-negligible percentage of patients.

Background: Mesothelioma is a deadly neoplasia related to asbestos, a mineral extensively used in Spain in the 1970-80s until its ban in 2001. The incidence of mesothelioma in the region of Vallès is 1.73 cases / 100,000 inhabitants / year, five times higher than the national average, due to the industrial activity of the area. This rise is likely to increase in the forthcoming years. Methods: We describe the epidemiological, diagnostic, pathological and therapeutic characteristics and the overall survival of 140 patients with mesothelioma diagnosed between April 1995 and December 2015 at a single center. Results: The median age was 70 years (44-89), 72.9% were males and 60% had been exposed to asbestos. A total of 55.7% were ECOG 0-1. The origin was pleural in 85% and peritoneal in 12.9%. Histology was: epithelioid in 45%, biphasic in 13.6%, sarcomatoid in 12.9% and unknown in 28.5%. All patients were clinically staged, 31.8% were EIII and 31.8% EIV. Pleurodesis was performed in 43.6%. Fifty percent of patients received palliative chemotherapy (66.2% a combination of platinum plus pemetrexed, 12.7% platinum plus gemcitabine). They received a median of 5 cycles (1-9). The response rate was 43.7%, with 26.8% stabilizations. Reasons for treatment discontinuation were: progression in 36.6% and toxicity in 12.7%. At the time of progression ECOG was 0-1 in 57.7%. Second-line treatment was administered in 46.5%. The median overall survival was 7.4 months (95% CI 4.98-9.91), with significant differences depending on the number of lines of treatment received: 0 vs. 1 vs. 2 (3, 8.5, 21.2 months p <0.001). Univariate analysis identified histology (p ¼ 0.033), localization (p <0.001), ECOG (p <0.001), leukocytosis (p ¼ 0.046) and LDH (p <0.001), as potential prognostic factors. Conclusion: The results are consistent with the published literature. We found significant differences in survival according to histology, location, ECOG and other prognostic factors previously explored.