title: Distinctive clinical characteristics of malignant mesothelioma in young patients.
abstract: Although considered a disease of the elderly, a subset of patients with mesothelioma are young (<40 years). The goal of this study was to understand their characteristics and outcomes. The Surveillance, Epidemiology, and End Results (SEER) database was used to extract mesothelioma cases (1990-2010). We modeled Kaplan-Meyer survival curves stratified by site of disease, and age of presentation. 2% (207 of 12345) of mesothelioma patients are young. Sex distribution is comparable among the young (51% males, 49% females); males predominated (78%, 22%) in the older cohort. Frequency of pleural and peritoneal mesothelioma are similar in the young (47%, 48% respectively); pleural disease predominated in the old (90%, 9%). Cancer-directed surgeries are more frequent in the young. Regardless of histologic subtype, young patients with pleural (11 vs. 8 months) and peritoneal (not reached vs. 10 months) mesothelioma had significantly improved overall survival. In multivariate analysis, younger age was an independent prognostic factor. Although rare, mesothelioma do occur in the young; their characteristics are distinct from those of older patients. Further studies are needed to understand the interplay between genetic susceptibility and mineral fiber carcinogenesis in the pathogenesis of mesothelioma in the young.
authors.affiliation: Thoracic and GI Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Anish
authors.initials: A
authors.lastname: Thomas
authors.affiliation: Thoracic and GI Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Yuanbin
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Office of Surveillance and Biometrics, Center for Devices and Radiological Health, FDA, Silver Spring, MD, USA.
authors.forename: Tinghui
authors.initials: T
authors.lastname: Yu
authors.affiliation: Meyer Orthopedic and Rehabilitation Hospital, Springfield, MO, USA.
authors.forename: Ammara
authors.initials: A
authors.lastname: Gill
authors.affiliation: Medical Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Vinay
authors.initials: V
authors.lastname: Prasad
mesh_terms: D000293:Adolescent; D000328:Adult; D001194:Asbestos / Q000009:adverse effects; D002648:Child; D004848:Epithelium / Q000473:pathology*; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000453:epidemiology* / Q000601:surgery; D008297:Male; D008654:Mesothelioma / Q000175:diagnosis* / Q000453:epidemiology* / Q000601:surgery; D000086002:Mesothelioma, Malignant; D010997:Pleural Neoplasms / Q000175:diagnosis* / Q000453:epidemiology* / Q000601:surgery; D011379:Prognosis; D018426:SEER Program; D055815:Young Adult
chemical_list: D001194:Asbestos
keywords: SEER analysis; asbestos; incidence among the young; mesothelioma