title: Clinical characteristics, treatment and survival outcomes in malignant pleural mesothelioma: an institutional experience in Turkey.
abstract: OBJECTIVE
  To compare treatment modalities and investigate potential prognostic factors for survival in patients with malignant pleural mesothelioma (MPM).
  
  
  METHODS
  The present study has investigated the data of 150 patients with MPM who were examined and treated in our center from 2005 to 2012.
  
  
  RESULTS
  The study included 87 male (58% and 63 female (42) patients. Surgical resection (pleurectomy/decortications (P/D), and extrapleural pneumonectomy (EPP)) was performed in 32 (36.7%) patients; 87 patients (58%) received chemotherapy alone and 16 (10.7%) had surgery, chemotherapy and radiotherapy (trimodal treatment). The median progression free and overall survival (PFS and OS) for all patients were 10.6 and 14.8 months, respectively. No statistically significant difference was observed between the patients who received pemetrexed/cisplatin (N=54) and gemcitabine/cisplatin (N=28) in terms of PFS and OS (p=0.145, p=0.244, respectively). Also, no statistically significant difference was registered between operated and non operated patients (PFS and OS, p=0.416, p=0.095, respectively). There was no difference in both PFS and OS rates between patients who had P/D or EPP (p=0.87, p=0.652, respectively). Log rank analysis: Eastern Cooperative Oncology Group performance status (ECOG PS) (p=0.018), histology (p<0.001), stage (p<0.001) and leukocytosis (p=0.005) were found to be significant prognostic factors of OS. At multivariate analysis, ECOG PS (p=0.016) and stage (p<0.001) were independent prognostic factors for OS.
  
  
  CONCLUSIONS
  Median OS was approximately 1 year. ECOG PS, histological type, stage and presence of leukocytosis were prognostic factors that affected both PFS and OS. EPP or P/D surgical options did not provide difference in terms of survival. Survival rates in patients who received a combination of platinum analogues with pemetrexed or gemcitabine as front-line chemotherapy were similar.
authors.affiliation: Department of Medical Oncology, Dicle University, Diyarbakir, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kucukoner
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ali Kaplan
authors.forename: Ali
authors.initials: A
authors.lastname: Inal
authors.forename: Zuhat
authors.initials: Z
authors.lastname: Urakci
authors.forename: Ozlem
authors.initials: O
authors.lastname: Abakay
authors.forename: Abdullah
authors.initials: A
authors.lastname: Cetin Tanrikulu
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Abakay
authors.forename: Hatice
authors.initials: H
authors.lastname: Selim Sen
authors.forename: Gul
authors.initials: G
authors.lastname: Turkcu
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Senyigit
authors.forename: Huseyin
authors.initials: H
authors.lastname: Buyukbayram
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Isikdogan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D018572:Disease-Free Survival; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D008297:Male; D008654:Mesothelioma / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D000086002:Mesothelioma, Malignant; D008875:Middle Aged; D010997:Pleural Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D019616:Thoracic Surgical Procedures; D016896:Treatment Outcome; D014421:Turkey; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D002945:Cisplatin; D000093542:Gemcitabine