Incidence, treatment and survival of malignant pleural and peritoneal mesothelioma: a population-based study

Abstract

IntroductionMalignant mesothelioma (MM) is an aggressive cancer that primarily arises from the pleura (MPM) or peritoneum (MPeM), mostly due to asbestos exposure. This study reviewed the Dutch population-based incidence, treatment and survival since the national ban on asbestos in 1993.Materials and methodsPatients with MPM or MPeM diagnosed from 1993 to 2018 were selected from the Dutch cancer registry. Annual percentage change (APC) was calculated for (age-specific and sex-specific) revised European standardised incidence rates (RESR). Treatment pattern and Kaplan-Meier overall survival analyses were performed.ResultsIn total, 12 168 patients were included in the study. For male patients younger than 80 years, the MM incidence significantly decreased in the last decade (APC ranging between −9.4% and −1.8%, p<0.01). Among both male and female patients aged over 80 years, the incidence significantly increased during the entire study period (APC 3.3% and 4.6%, respectively, p<0.01). From 2003 onwards, the use of systemic chemotherapy increased especially for MPM (from 9.3% to 39.4%). Overall, 62.2% of patients received no antitumour treatment. The most common reasons for not undergoing antitumour treatment were patient preference (42%) and performance status (25.6%). The median overall survival improved from 7.3 (1993–2003) to 8.9 (2004–2011) and 9.3 months from 2012 to 2018 (p<0.001).ConclusionThe peak of MM incidence was reached around 2010 in the Netherlands, and currently the incidence is declining in most age groups. The use of systemic chemotherapy increased from 2003, which likely resulted in improved overall survival over time. The majority of patients do not receive treatment though and prognosis is still poor.

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

“…this is similar to the correlation found in chinese study involving 1110 MPM patients showing median survival time was 17, 13, 12, 8, 6, 5 months for IA, IB, II, IIIA, IIIB, and IV, respectively (19) . This is also evident in a Dutch study conducted among 12,168 patients showed that patients diagnosed with stage I pleural mesothelioma had a median survival of 13.1 months compared with 5.7 months for patients with stage IV disease (25) . Also, patients with better performance status of ECOG 0-1 showed better OS of 11 months compared with ECOG 2 with median OS 8 months and ECOG 3 with only 2 months median OS (P value 0.001).…”

Clinical epidemiology of peritoneal metastases in China: The construction of professional peritoneal metastases treatment centers based on the prevalence rate

“…van Kooten JP et al [8] retrospectively analyzed 629 MPM patients registered at the National Cancer Center in the Netherlands from 1993 to 2018, and it showed that the survival rate of MPM patients who received chemotherapy and/or surgery was close to zero after 3 years of follow-up. Therefore, this study used 3 years (The length of time required to receive clinical treatment) as the observation period for MPM patients.…”

Thoracic surgery in the Netherlands

“…The Netherlands ranks in the top five worldwide regarding the incidence of mesothelioma (46,47). Mesothelioma is strongly correlated with asbestos use (46)(47)(48), which application peaked between 1970 and 1980 (49). Since 1993, use of asbestos is legally prohibited in the Netherlands.…”

“…Since 1993, use of asbestos is legally prohibited in the Netherlands. Nevertheless, the long-term effects are present in daily practice with an incidence in 2018 of 3.3 cases per 100,000 person-years ( 49 ). Treatment of mesothelioma is performed in tertiary centers.…”