Surgery Extends Survival with Malignant Pleural Mesothelioma

Pleural mesothelioma is a rare cancer that has been linked to asbestos exposure caused by a victim’s living environment or occupation. The prognosis is dire if pleural mesothelioma is left untreated, but patients have seen their prognosis improve with surgical procedures. It has been suggested that multimodal surgery provides better results, but there has been no study proving this theory. A Surveillance, Epidemiology, and End Results study (SEER study) of 14,228 patients was performed to see if surgery resulted in better survival rates or if other predictors influenced survival rates.

By using the SEER database to analyze the age, sex, race, year of diagnosis, histology stage, cancer-directed surgery, radiation, and vital status of mesothelioma patients between 1973 and 2009, scientists were able to determine which patients had the best survival prognosis. The predictors that resulted in the highest survival rates were if a patient was female, younger in age, in early stages of cancer and previously had related surgery. The data also showed that survival prognosis did not improve for pleural mesothelioma patients despite advancements in surgery and radiation techniques. It is believed that a multimodal surgery therapy provides better results for pleural mesothelioma patients.

Pleural mesothelioma patients who did not have surgery or radiation treatment had a lower survival rate than those who had surgery alone. When comparing patients who had surgery against those who had radiation treatments and surgery, there were no significant differences in survival rates. It was also determined that surgery alone increased patients’ survival rates, no matter what the predictors were across the board.

There were some limitations to this SEER study for pleural mesothelioma patients. Some predictors were not tracked, such as pulmonary and cardiac functions. The data also did not take into account if the intent was to cure the disease or simply provide a palliative treatment. The levels of radiation were not properly tracked, so that data was not included in the study.

Resources:
Taioli, E., Wolf, A.S., Camacho-Rivera, M., Kaufman, A., Lee, D., Nicastri, D., … Flores, R.M. (2015). Determinants of Survival in Malignant Pleural Mesothelioma: A Surveillance, Epidemiology, and End Results (SEER) Study of 14,228 Patients. Retrieved from http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0145039

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