title: Survival of pleural malignant mesothelioma in Italy: a population-based study.
abstract: A median survival time of about 9 months is generally reported among malignant pleural mesothelioma cases. Recently, better results in terms of survival and performance status have been reported in clinical trials that included highly selected patients. We describe the survival of pleural mesothelioma patients and the factors predictive of survival in an unselected, population-based setting. Pleural mesothelioma cases (4,100) registered from 1990 to 2001 by 9 Italian regional mesothelioma registries contributing to the network of the National Mesothelioma Registry were followed until December 31, 2005. Univariate (Kaplan-Meier) and multivariate (Cox proportional hazards regression) analyses of survival were carried out according to selected individual characteristics, including limited information on treatment in a subset of 578 cases. The median survival time was 9.8 months (95% confidence interval: 9.4-10.1). In multivariate analysis, younger age at diagnosis and epithelioid histotype were associated with significantly reduced hazard ratios. Positive effects of gender (women) and being diagnosed in a hospital with a thoracic surgery unit were of border-line statistical significance. No association with calendar period of diagnosis or asbestos exposure was present. Treatment was not associated with a statistically significant improvement in survival. This is the largest population-based study on survival in patients with pleural mesothelioma to date. Age and morphology were the main prognostic factors. Results regarding the effect of treatment were disappointing but may be useful to assess the future impact, at the population level, of recently introduced therapies.
authors.affiliation: Department of Epidemiology and Prevention, Liguria Mesothelioma Registry, National Cancer Research Institute IST, Genoa, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Montanaro
authors.forename: Rosalba
authors.initials: R
authors.lastname: Rosato
authors.forename: Manuela
authors.initials: M
authors.lastname: Gangemi
authors.forename: Sara
authors.initials: S
authors.lastname: Roberti
authors.forename: Fulvio
authors.initials: F
authors.lastname: Ricceri
authors.forename: Enzo
authors.initials: E
authors.lastname: Merler
authors.forename: Valerio
authors.initials: V
authors.lastname: Gennaro
authors.forename: Antonio
authors.initials: A
authors.lastname: Romanelli
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Chellini
authors.forename: Cristiana
authors.initials: C
authors.lastname: Pascucci
authors.forename: Marina
authors.initials: M
authors.lastname: Musti
authors.forename: Carmela
authors.initials: C
authors.lastname: Nicita
authors.forename: Pietro Gino
authors.initials: PG
authors.lastname: Barbieri
authors.forename: Alessandro
authors.initials: A
authors.lastname: Marinaccio
authors.forename: Corrado
authors.initials: C
authors.lastname: Magnani
authors.forename: Dario
authors.initials: D
authors.lastname: Mirabelli
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008654:Mesothelioma / Q000401:mortality* / Q000628:therapy; D008875:Middle Aged; D015999:Multivariate Analysis; D010997:Pleural Neoplasms / Q000401:mortality* / Q000628:therapy; D011379:Prognosis; D016016:Proportional Hazards Models; D012042:Registries; D016896:Treatment Outcome