A review of malignant pleural mesothelioma in a large North East UK pleural centre

Murphy, Declan C; Mount, Alexander; Starkie, Fiona; Taylor, Leah; Aujayeb, Avinash

doi:10.1515/pp-2020-0144

Cited by 5 publications

(4 citation statements)

References 14 publications

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“…The ratios of staging recorded and actual rates of histopathological con rmation in this study were 92% and 98.8%, respectively, which is quite high compared with a recent UK report (Murphy 2020, Beckett 2015. These results suggest that the information obtained in this study is reliable.…”

Section: Discussionsupporting

confidence: 61%

Multi-institutional survey of malignant pleural mesothelioma patients in the Hokushin region

Uramoto

Takiguchi

Koizumi

et al. 2021

J Cancer Res Clin Oncol

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Background: Malignant pleural mesothelioma (MPM) is a major occupational and environmental neoplasm. The purpose of this study was to validate the clinical and epidemiological factors, diagnosis, and initial treatment among MPM patients.Methods: We surveyed retrospective data from 152,921 cancer patients in 22 principal hospitals.Results: A total of 166 MPM cases were newly diagnosed. These patients consisted of 136 men and 30 women, with a median age of 69 years old. We estimated the incidence rate for MPM to be 0.55 cases per 100,000 person-years in this study. The ratio per 100,000 population-years was 0.39 in Fukui, 0.60 in Ishikawa, 1.02 in Toyama and 0.35 in Nagano. Forty-ve patients were discovered at follow-up of other diseases. Forty-six cases were diagnosed as localized disease, while 13 had accompanying regional lymph node metastasis. Furthermore, 44 cases showed in ltration into adjacent organs. A histocytological diagnosis was made in 164 cases (98.8%). A surgical approach, chemotherapy, and radiotherapy were performed for 33, 88, and 6 patients, respectively, while 44 patients (26.5%) received best supportive care. Multimodality therapy was conducted in just 3.0% of the MPM patients. Conclusion: MPM has a tragically rapid progression if discovered during follow-up of other diseases.Workers in health-related elds should be on high alert for aggressive MPM. New therapeutic options for MPM are urgently required.

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Section: Discussionsupporting

confidence: 61%

Multi-institutional survey of malignant pleural mesothelioma patients in the Hokushin region

Uramoto

Takiguchi

Koizumi

et al. 2021

J Cancer Res Clin Oncol

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“…The most common presenting symptoms were dyspnea (77.4%), chest pain (38.5%), unintentional weight loss (29.9%) and fatigue (10.1%). 7.3% were asymptomatic (18) . Tissue diagnosis was done through thoracoscopic biopsies in 56.7% of the patients while US and CT guided biopsies were used in 28.3% and 6.7% of the patients respectively, while 6.7% relied on cytology and immunohistochemistry performed on tapped pleural effusion and only 1.6% of the patients had no records of used tissue biopsy.…”

Section: Discussionmentioning

confidence: 96%

“…Compared to the previously mentioned UK study, Totally, only 86.8% of patients underwent biopsy for histopathological characterization, however unlike our study, most commonly performed method was a pleural tap (59.1%), followed by Local anesthesia thoracoscopy LAT (48.6%), CT-guided biopsy(20.2%), ultrasound-guided biopsy (8.9%) and surgical biopsy (4.3%). As noticed, some patients underwent more than one method to confirm diagnosis (18) .…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Analysis of Epidemiological Features and Clinical Outcomes of Patients With Malignant Pleural Mesothelioma Treated in Ain Shams Clinical Oncology Department in the Period From 2017 to 2020

Sadek

Mostafa

Ahmed

et al. 2022

Ain Shams Medical Journal

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Background: Mesothelioma is a rare tumor strongly associated with exposure to carcinogens, particularly asbestos. The study aimed to detect the epidemiological features of patients with malignant pleural mesothelioma treated in Ain Shams university hospital and different treatment outcomes Aim of work: To analyze retrospectively epidemiological and clinical outcomes of malignant pleural mesothelioma patients treated in Ain Shams University Hospitals (ASU) in Cairo, Egypt, from 2017 to 2020.Patients and methods: convenient sampling of 120 patients with malignant pleural mesothelioma. The primary objective was to analyze the epidemiological and demographic data while secondary objectives included calculating overall survival as well as correlation between different clinic-pathological factors and outcome.Results: 120 participants were included, with a median age of 56.5, male to female ratio of 1:1.14. Incidence was highest in industrial areas Shobra Al Khaimah and Helwan as compared to other areas, 35.8%, 15% and 49.2% respectively. Epithelioid subtype represents 86.6% of the patients, while 6.6% of the patients are biphasic subtype and only 2.5% sarcomatoid subtype.The most common presenting symptom was dyspnea, followed by chest pain. Only 6.7% of the patients were candidates for surgery whether after chemotherapy or upfront, while 77.5% of the patients were candidates for first line chemotherapy and only 15.8% received radiotherapy, all with palliative intent.Conclusion: Mesothelioma in Egypt is mainly concentrated in areas of high environmental pollution. We aimed to provide retrospective data of epidemiological, clinic-pathological and outcomes of adult MPM patients. Better environmental control programme would benefit Egypt.

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“…This study also raised additional concerns. The impact of performance status and histologic subtype on survival of patients with MPM is paramount for any treatment [14][15][16][17] ; therefore, the absence of patients with performance status of 2 in the CM743 trial and the inclusion of nonepithelioid cases in MAPS should be also more carefully analyzed before declaring CM743 superiority.…”

Section: Discussionmentioning

confidence: 99%

Comparison of 3 Randomized Clinical Trials of Frontline Therapies for Malignant Pleural Mesothelioma

et al. 2022

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IMPORTANCE Some recently proposed frontline therapies for malignant pleural mesothelioma (MPM) are very costly, yet their impact on quality of life and overall survival of these patients remains arguable. Given the high social toll of this aggressive occupational cancer, it is paramount to establish the real clinical benefit of these treatments. OBJECTIVETo directly compare and analyze the statistical robustness of the 3 randomized clinical trials (RCTs) of frontline therapies recommended for MPM since 2003. DESIGN, SETTING, AND PARTICIPANTS This comparative effectiveness study assessed the following phase 3 RCTs: the Mesothelioma Cisplatin Pemetrexed Study (MPS) of cisplatin plus pemetrexed vs cisplatin; the Mesothelioma Avastin Cisplatin Pemetrexed Study (MAPS) of cisplatin plus pemetrexed plus bevacizumab vs cisplatin plus pemetrexed; and the CheckMate743 (CM743) study of nivolumab plus ipilimumab vs cisplatin plus pemetrexed. Data collection dates for the RCTs ranged from April 1999 to April 2018. Data for this study were analyzed from February to October 2021. MAIN OUTCOMES AND MEASURES Patient selection criteria, superiority of the intervention groups, survival-inferred fragility index, and censoring patterns in each RCT. RESULTS A total of 1501 patients were included in the analysis (1170 men [77.9%]; range of median age for treatment groups, 60 [IQR, 19-84] to 69 [IQR, 65-75] years). A virtual comparison of overall survival in MAPS vs the CM743 study showed no statistically significant difference (hazard ratio [HR], 0.97 [95% CI, 0.79-1.20]; P = .79), and the survival-inferred fragility index in the intention-to-treat (ITT) populations was as low as 0.22% of the total sample size in MPS, −0.45% of the total sample size in MAPS, and 0.99% of the total sample size in the CM743 trial. Moreover, reverse restricted mean survival time (RMST) analysis of overall survival using RMST-difference (RMST-D) demonstrated differential censoring in the ITT population of the CM743 trial favoring the control group (0.56 [95% CI, 0.18-0.94]; P = .004) and in the nonepithelioid group (reverse RMST-D, 0.90 [95% CI, 0.001-1.79]; P = .048). CONCLUSIONS AND RELEVANCEThis comparative effectiveness study found no survival benefit in the CM743 trial over MAPS, despite the inclusion of patients with worse prognosis in the latter trial.Moreover, the statistical conclusions of all the examined trials were shown to be extremely fragile, and the findings of differential censoring in the CM743 trial and in the ITT nonepithelial subset raised additional areas of concern. These findings suggest that selection criteria, fragility, and censoring patterns may affect the original conclusions drawn for the respective trials, casting a shadow on the (continued)

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A review of malignant pleural mesothelioma in a large North East UK pleural centre

Cited by 5 publications

References 14 publications

Multi-institutional survey of malignant pleural mesothelioma patients in the Hokushin region

Multi-institutional survey of malignant pleural mesothelioma patients in the Hokushin region

A Retrospective Analysis of Epidemiological Features and Clinical Outcomes of Patients With Malignant Pleural Mesothelioma Treated in Ain Shams Clinical Oncology Department in the Period From 2017 to 2020

Comparison of 3 Randomized Clinical Trials of Frontline Therapies for Malignant Pleural Mesothelioma

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