[Survival analysis of malignant mesothelioma treated in Brescia, northern Italy, 1982-2000].
OBJECTIVE
To study the survival for malignant mesothelioma on general population cases over the 1982-2000 period and to evaluate the effectiveness of the new therapeutic protocols (intrapleural immunotherapy and mulitmodality therapy) to improve the prognosis on the group of selected hospital patients treated from 1996 to 2000.


METHODS
Survival analysis of malignant mesothelioma on the general population cases and survival analysis for the 1996-2000 period on the selected group of hospital patients.


METHODS
The Malignant Mesothelioma Register of the Brescia Province (northern Italy) and Pulmonology Dept. of the General hospital of Brescia.


METHODS
353 mesothelioma cases observed in the province of Brescia from 1982 to 2000, 215 of which are residents in the province and 138 from other provinces, 324 are pleural and 29 peritoneal mesothelioma, 141 of all diagnosed between 1982 and 1995 and 212 between 1996 and 2000.


METHODS
Observed survival (%) at one, three, five-year and median survival by gender, site and residence on the general population cases treated with conventional therapy and on selected hospital patients group treated with intrapleural immunotherapy and mulimodality therapy.


RESULTS
Median survival for pleural mesothelioma is of 233 days for the men and 291 days for the women in the group of incident cases; median survival is higher for cases from other provinces (388 and 496 days respectively). From 1996 the number of cases treated with new therapic protocols is steadily increasing, patients without therapy (or only talcaggio) passed from 87% in the period between 1982-1995 to 43% in the period 1996-2000. Nevertheless, multivariate analysis by the Cox model based on incident cases proved that histological subtype and age are the only most important prognostic factors (cases with fibrous morphology and older age are associated with lower survival).


CONCLUSIONS
In the incident case group the increase of survival for pleural mesothelioma of cases treated with recent therapeutic protocols doesn't reach statistical significance. These results are similar to those of previous studies conducted to identify prognostic factors for mesothelioma survival; they don't permit confirmation of the efficacy of the recent therapy on the population base cases and only allow one to suppose them in the cases of the non resident population. The efficacy of the recent therapy has to be further investigated with regard to the stage of the disease.
Barbieri
Pietro Gino
PG
Servizio prevenzione e sicurezza ambienti di lavoro, ASL Provincia di Brescia. pietro.barbieri@aslbrescia.it
Marinaccio
Alessandro
A
Festa
Roberto
R
Nesti
Massimo
M
Marchetti
Giampietro
G
Trigiani
Marco
M
Tassi
Gianfranco
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D002391:Catchment Area, Health; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008654:Mesothelioma / Q000453:epidemiology / Q000401:mortality* / Q000628:therapy*; D008875:Middle Aged; D015996:Survival Rate