title: Characteristics of malignant pleural mesothelioma in women.
abstract: BACKGROUND
  The incidence of malignant pleural mesothelioma (MPM) is higher in men than in women, likely due to increased occupational asbestos exposure among men. Women also appear to experience better long-term survival. This study evaluates the role of gender in relation to established prognostic factors in MPM.
  
  
  METHODS
  We reviewed 715 cases of MPM treated with extrapleural pneumonectomy at our institution between July 1987 and December 2008. Data for patients with epithelial and nonepithelial tumors were analyzed separately. Kaplan-Meier and Cox regression analyses were used to estimate survival for various cohorts to assess the relationship between gender and survival independent of age at surgery, stage, side, and preoperative laboratory studies.
  
  
  RESULTS
  Of the 702 patients with complete data available, 114 out of 450 patients with epithelial tumors and 31 out of 252 patients with nonepithelial histology were women. Women with epithelial (and not nonepithelial) disease were found to differ significantly from men with respect to younger age, higher rate of thrombocytosis, and longer survival after surgery. The effect of gender on survival of patients with epithelial disease persisted when controlling for age, stage, thrombocytosis, leukocytosis, and anemia with a multivariable analysis. No significant differences in survival were seen among patients with nonepithelial disease with regard to gender, age, or anemia.
  
  
  CONCLUSIONS
  In the absence of other negative prognostic factors, women with epithelial MPM demonstrated a survival advantage. These findings support an aggressive approach to treating MPM including extrapleural pneumonectomy in individuals with favorable prognostic predictors, particularly women with epithelial histology and no other risk factors.
authors: Division of Thoracic Surgery, Brigham and Women's Hospital, Boston, Massachusetts 02215, USA. awolf2@partners.org
authors: Andrea S
authors: AS
authors: Wolf
authors: William G
authors: WG
authors: Richards
authors: Tamara R
authors: TR
authors: Tilleman
authors: Lucian
authors: L
authors: Chirieac
authors: Shelley
authors: S
authors: Hurwitz
authors: Raphael
authors: R
authors: Bueno
authors: David J
authors: DJ
authors: Sugarbaker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008654:Mesothelioma / Q000401:mortality*; D008875:Middle Aged; D010997:Pleural Neoplasms / Q000401:mortality*; D011379:Prognosis; D012189:Retrospective Studies; D012737:Sex Factors; D015996:Survival Rate; D055815:Young Adult