title: Management of malignant pleural mesothelioma - part 3 : Data from the Austrian Mesothelioma Interest Group (AMIG) database.
abstract: BACKGROUND
  Malignant pleural mesothelioma (MPM) is a rare but aggressive tumor originating from the pleural cavity with a strong link to previous asbestos exposure. In order to determine the demographics, diagnostics, therapeutic strategies, and prognosis of MPM patients in Austria, the Austrian Mesothelioma Interest Group (AMIG) was founded in 2011. In this report the data from the AMIG MPM database collected to date are reported.
  
  
  METHODS
  A prospective observational registry was initiated, including patients with histologically verified MPM diagnosed and treated at specialized centers in Austria. Patient inclusion started in January 2011 and follow-up was completed until September 2015.
  
  
  RESULTS
  A total number of 210 patients were included. There were 167 male and 43 female patients with a mean age of 67.0 years (SD ± 11.3) at the time of diagnosis. Asbestos exposure was confirmed in 109 (69.4 %) patients. The histological subtype was epithelioid in 141 (67.2 %), sarcomatoid in 16 (7.6 %), biphasic in 28 (13.3 %), and MPM not otherwise specified in 25 (11.9 %) patients. Of the patients, 30 (14.3 %) received best supportive care (BSC) only, 71 (33.8 %) chemotherapy (CHT) alone, four (1.9 %) radiotherapy (RT) alone, 23 (11.9 %) CHT/RT, two (0.9 %) surgery alone, and 76 (36.2 %) curative surgery within a multimodality treatment (MMT), which was more frequently performed for patients younger than 65 years and with early-stage disease (I + II). Median overall survival (OS) was 19.1 months (95 % CI 14.7-23.5). The 1‑, 3‑, and 5‑year OS rates were 66 %, 30 %, and 23 %, respectively, and OS was significantly better in patients undergoing surgery within MMT (5-year survival 5 % vs. 40 %, p = 0.001).
  
  
  CONCLUSIONS
  Patients with earlier disease stages, younger age, good performance status, and epithelioid histology were more likely to undergo MMT including surgery, which resulted in a more favorable outcome.
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Comprehensive Cancer Center, Medical University Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Klikovits
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Comprehensive Cancer Center, Medical University Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria. mir.hoda@meduniwien.ac.at.
authors.forename: Mir Alireza
authors.identifier: http://orcid.org/0000-0002-7088-8768
authors.initials: MA
authors.lastname: Hoda
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Comprehensive Cancer Center, Medical University Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
authors.forename: Yawen
authors.initials: Y
authors.lastname: Dong
authors.affiliation: Department of Pulmonology, LKH Hochegg, Hochegg, Austria.
authors.forename: Madeleine
authors.initials: M
authors.lastname: Arns
authors.affiliation: Department of Pulmonology, Landeskrankenhaus Vöklabruck, Vöklabruck, Austria.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Baumgartner
authors.affiliation: Department of Pulmonology, University Clinic Krems, Krems, Austria.
authors.forename: Peter
authors.initials: P
authors.lastname: Errhalt
authors.affiliation: Department of Pulmonology, Klinikum Klagenfurt, Klagenfurt, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Geltner
authors.affiliation: Rehabilitation Center Tobelbad, Allgemeine Unfallversicherungsanstalt, Tobelbad, Austria.
authors.forename: Barbara
authors.initials: B
authors.lastname: Machan
authors.affiliation: Department of Pneumology, KH Hietzing, Karl Landsteiner Institute for Clinical and Experimental Pneumology, Vienna, Austria.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Pohl
authors.affiliation: Department of Surgery, University Clinic Salzburg, Salzburg, Austria.
authors.forename: Jörg
authors.initials: J
authors.lastname: Hutter
authors.affiliation: Department of Pulmonology, Landeskrankenhaus Wels, Wels, Austria.
authors.forename: Josef
authors.initials: J
authors.lastname: Eckmayr
authors.affiliation: Department of Pulmonology, University Clinic Salzburg, Salzburg, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Studnicka
authors.affiliation: Department of Pulmonology, Landeskrankenhaus Leoben, Leoben, Austria.
authors.forename: Martin
authors.initials: M
authors.lastname: Flicker
authors.affiliation: Department of Pulmonology, Landeskrankenhaus Hohenems, Hohenems, Austria.
authors.forename: Peter
authors.initials: P
authors.lastname: Cerkl
authors.affiliation: Department of Pulmonology, Wilhelminenspital Vienna, Vienna, Austria.
authors.forename: Klaus
authors.initials: K
authors.lastname: Kirchbacher
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Comprehensive Cancer Center, Medical University Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
authors.forename: Walter
authors.initials: W
authors.lastname: Klepetko
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001195:Asbestosis / Q000401:mortality*; D001317:Austria / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008654:Mesothelioma / Q000175:diagnosis* / Q000401:mortality*; D008875:Middle Aged; D016066:Pleural Effusion, Malignant / Q000401:mortality*; D010997:Pleural Neoplasms / Q000401:mortality*; D015995:Prevalence; D012042:Registries; D012307:Risk Factors; D017678:Sex Distribution; D015996:Survival Rate
keywords: Epidemiology; Malignant pleural mesothelioma; Outcome; Treatment; Tumor registry