Clinical Features in Patients With Malignant Pleural Mesothelioma With 5-Year Survival and Evaluation of Original Diagnoses

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Paajanen , J , Laaksonen , S , Ilonen , I , Vehmas , T , Mäyränpää , M I , Sutinen , E , Kettunen , E , Salo , J A , Räsänen , J , Wolff , H & Myllärniemi , M 2020 , ' Clinical Features in Patients With Malignant Pleural Mesothelioma With 5-Year Survival and Evaluation of Original Diagnoses ' , Clinical Lung Cancer , vol. 21 , no. 6 , pp. E633-E639 . https://doi.org/10.1016/j.cllc.2020.05.020

Title: Clinical Features in Patients With Malignant Pleural Mesothelioma With 5-Year Survival and Evaluation of Original Diagnoses
Author: Paajanen, Juuso; Laaksonen, Sanna; Ilonen, Ilkka; Vehmas, Tapio; Mäyränpää, Mikko I.; Sutinen, Eva; Kettunen, Eeva; Salo, Jarmo A.; Räsänen, Jari; Wolff, Henrik; Myllärniemi, Marjukka
Contributor: University of Helsinki, HUS Heart and Lung Center
University of Helsinki, Faculty of Medicine
University of Helsinki, Department of Surgery
University of Helsinki, HUSLAB
University of Helsinki, HUS Heart and Lung Center
University of Helsinki, Clinicum
University of Helsinki, HUS Heart and Lung Center
University of Helsinki, Finnish Institute of Occupational Health
University of Helsinki, HUS Heart and Lung Center
Date: 2020-11
Language: eng
Number of pages: 7
Belongs to series: Clinical Lung Cancer
ISSN: 1525-7304
URI: http://hdl.handle.net/10138/330183
Abstract: Within a larger national malignant pleural mesothelioma cohort, we identified 43 patients with unusually long survival times. This study aimed to evaluate the diagnostic accuracy in this subgroup, and the diagnosis was confirmed to be correct in most cases. In addition, we searched for clinical factors related to the prolonged survival time. Introduction: Malignant pleural mesothelioma (MPM) is a fatal malignancy strongly associated with previous asbestos exposure. Overall survival remains dismal, partly owing to poor response to available treatment. The aims of this study were to evaluate diagnostic accuracy in a group of patients with MPM with an unusually long survival time and to assess the factors related to this prolonged survival. Materials and Methods: Forty-three patients with overall survival exceeding 5 years were accepted to the long-term survivor (LTS) group, and these patients were compared with 84 patients with epithelial MPM. Data were collected from various national registries and electronic medical records. In addition, all available histopathologic diagnostic samples and computed tomography studies were re-evaluated by experienced specialists. Results: Our study showed a good diagnostic accuracy, with only 1 (0.5%) patient having an incorrect MPM diagnosis. Two (0.9%) localized malignant mesotheliomas and 2 (0.9%) well-differentiated papillary mesotheliomas were also found. LTS patients were younger, more frequently female, had a better performance status at time of diagnosis, and had less evidence of prior asbestos exposure. In multivariate analysis, we showed tumor size, Eastern Cooperative Oncology Group performance status, and first-line treatment (both surgery and chemotherapy) to be associated with survival time. Conclusion: We confirmed the diagnosis of MPM in an overwhelming majority of patients in the LTS group. An epithelial subtype of MPM behaving clinically more indolently seems to exist, but further tumor and genetic characterization is needed. The prolonged survival time is most likely explained by a combination of tumor-, patient-, and treatment-related factors. (C) 2020 Elsevier Inc. All rights reserved.
Subject: Clinical factors
Diagnostic assessment
Long-term survivors
Prognostic factors
Survival time
LONG-TERM SURVIVAL
PROGNOSTIC-FACTORS
BIOMARKERS
HISTORY
SURGERY
FUTURE
SCORE
3122 Cancers
3121 General medicine, internal medicine and other clinical medicine
3126 Surgery, anesthesiology, intensive care, radiology
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