Demographics and Survival in Malignant Pleural Mesothelioma: Analysis of Seer Data
Journal of Thoracic Oncology
Background: Mesothelioma is an uncommon malignancy arising in 80% of cases from the mesothelial lining of the pleura. Less frequently it can originate in the peritoneum, pericardium or the tunica vaginalis. Prognosis remains extremely poor even with treatment and data regarding the demographics and survival of mesothelioma is poorly described owing to its rarity. Method: Using ICD-O-3 histology code 9050 in the Surveillance Epidemiology and End Results database (SEER), demographics and survival data on malignant pleural mesothelioma (MPM) diagnosed between 2005 and 2015 were abstracted. JMP 14 statistical software was used for data analysis. The SEER database does not record specific age above 85 years; for this reason, 872 cases were excluded. Results: A total of 3709 cases of MPM were identified. Most were Caucasian (3336, 90%) and male (2787, 75%); the average age was 70 ± 11 years. Overall, 1574 patients (42%) received chemotherapy. Median 10-year survival was 8 months (95% CI 8 to 9 months). Patients who received chemotherapy had improved survival (11 months, 95% CI 11 to 12 months) compared to those who did not (5 months, 95% CI 5 to 6 months, p<0.0001). In a proportional hazards model, male sex and age at diagnosis were associated with increased mortality (HR 1.23, 95% CI 1.13-1.33 and HR 1.026, per unit increase, 95% CI 1.022-1.029 respectively); use of chemotherapy and Caucasian ethnicity were associated with improved survival (HR 0.80, 95% CI 0.74-0.85, HR 0.93 95% CI 0.83-1.05). Age, male sex and use of chemotherapy proved statistically significant (p<0.05). Conclusion: These results serve as confirmation of the poor prognosis of MPM despite chemotherapy as detailed in prior published data. In our analysis, elderly Caucasian males were most commonly affected. Improved survival was observed with use of standard chemotherapy. Several phase 1 and 2 trials have shown a promising response to check point inhibitors. As such, overall survival is liable to change in the next decade with the advent of new therapeutic modalities.
11, Supplement 1
Anusium, N; Ionescu, F; and Jaiyesimi, I, "Demographics and Survival in Malignant Pleural Mesothelioma: Analysis of Seer Data" (2019). Conference Presentation Abstracts. 21.