Prognostic factors for progression‐free and overall survival in malignant pleural mesothelioma

Abstract

Background Malignant pleural mesothelioma is an infrequent neoplasia with a poor prognosis and the majority of patients already have advanced disease at the time of presentation. Exposure to asbestos is the most important risk factor for malignant pleural mesothelioma. Mesothelioma is a neoplasia with a long preclinical stage that can span from 15 to 40 years. Methods This was a descriptive, observational, retrospective study of 136 patients with a confirmed diagnosis of mesothelioma, which compared histological subtypes, immunohistochemical biomarkers, concomitant chronic degenerative diseases, tobacco use, age at the time of diagnosis, clinical stage and chemotherapy agents used or other treatments such as radiotherapy and surgery to identify all the factors that impact in the prognosis of overall survival (OS) and progression‐free survival (PFS). Results A total of 136 patients were included in the study. In the total study population, 84 patients were male (61.8%) and 52 were female (38.2%). Median PFS was nine months (95% confidence interval [CI]: 8.4–9.5 months) and median OS was 12 months (95% CI: 11.3–12.6). The results indicated that the most determining prognostic factors for OS and PFS were cell differentiation measured by immunohistochemical biomarkers, the treatment chosen, and that RECIST was the most significant in the evaluation of patient response to treatment. Conclusions Malignant pleural mesothelioma is a cancer with a poor prognosis usually diagnosed at an advanced stage of disease. Our study revealed that the prognostic factors for OS and PS were cell differentiation, the treatment chosen and RECIST.

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

“…In addition, 18 patients (13.2%) received radiotherapy, 19 (14.0%) had surgery of which nine (6.6%) had pleuro-pneumonectomy and 10 (7.4%) had pleurectomy. The median PFS was nine months (95% CI: 8.4 to9.5 months) and the median OS was 12 months (95% CI:11.3 to 12.6) (22) .…”

Survival analysis and development of a prognostic nomogram for patients with malignant mesothelioma in different anatomic sites

“…For example, the median survival time for malignant pleural mesothelioma is about 10-12 months ( 18 ), which is worse than reported in our study ( Table 2 ). It may be because most (80%) patients with malignant pleural mesothelioma are typically diagnosed when the disease has progressed to an advanced stage ( 19 ). Individualized surgical treatment is not available for these patients ( 17 , 20 ).…”

“…Individualized surgical treatment is not available for these patients ( 17 , 20 ). Chemotherapy and other treatments also have a limited effect ( 21 ), thus leading to poor prognosis ( 19 ). The severe phase of MMe can be avoided by early identification of risk factors for the disease.…”

The state of the art for artificial intelligence in lung digital pathology

“…Pleural mesothelioma is a rare malignancy of the pleura, with a poor prognosis [138]. Courtiol et al [67] developed MesoNet, a fully unsupervised deep CNN using WSIs to predict the overall survival of mesothelioma patients without any pathologist‐provided locally annotated regions.…”