Predicting survival in malignant mesothelioma

Malignant mesothelioma (MM) of the pleura or peritoneum is a universally fatal disease attracting an increasing range of medical interventions and escalating healthcare costs. Changes in survival and the factors affecting survival of all patients ever diagnosed with MM in Western Australia over the...

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Main Authors: Musk, A., Olsen, N., Alfonso, Helman, Reid, Alison, Mina, R., Franklin, P., Sleith, J., Hammond, N., Threlfall, T., Shilkin, K., De Klerk, N.
Format: Journal Article
Published: 2011
Online Access:http://hdl.handle.net/20.500.11937/20002
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author Musk, A.
Olsen, N.
Alfonso, Helman
Reid, Alison
Mina, R.
Franklin, P.
Sleith, J.
Hammond, N.
Threlfall, T.
Shilkin, K.
De Klerk, N.
author_facet Musk, A.
Olsen, N.
Alfonso, Helman
Reid, Alison
Mina, R.
Franklin, P.
Sleith, J.
Hammond, N.
Threlfall, T.
Shilkin, K.
De Klerk, N.
author_sort Musk, A.
building Curtin Institutional Repository
collection Online Access
description Malignant mesothelioma (MM) of the pleura or peritoneum is a universally fatal disease attracting an increasing range of medical interventions and escalating healthcare costs. Changes in survival and the factors affecting survival of all patients ever diagnosed with MM in Western Australia over the past five decades and confirmed by the Western Australian Mesothelioma Registry to December 2005 were examined. Sex, age, date and method of diagnosis, site of disease and histological type were recorded. Date of onset of symptoms and performance status were obtained from clinical notes for a sample of cases. Cox regression was used to examine the association of the clinical variables and the 10-yr periods of disease onset with survival after diagnosis. Survival was inversely related to age, being worse for males (hazard ratio (HR) 1.4, 95% CI 1.2-1.6), and those with peritoneal mesothelioma (HR 1.4, 95% CI 1.1-1.7). Patients with sarcomatoid histology had worse prognosis than patients with epithelioid and biphasic histological subtypes. Survival improved after the 1970s and has made incremental improvements since then. Median (interquartile range) survival by decade, from 1960 until 2005, was 64 (0-198), 177 (48-350), 221 (97-504), 238 (108-502) and 301 (134-611) days; ~4 weeks of this apparent improvement can be attributed to earlier diagnosis. With increasing resources and treatment costs for MM over the past 40 yrs, there have been modest improvements in survival but no complete remissions. Copyright©ERS 2011.
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spelling curtin-20.500.11937-200022017-09-13T13:51:43Z Predicting survival in malignant mesothelioma Musk, A. Olsen, N. Alfonso, Helman Reid, Alison Mina, R. Franklin, P. Sleith, J. Hammond, N. Threlfall, T. Shilkin, K. De Klerk, N. Malignant mesothelioma (MM) of the pleura or peritoneum is a universally fatal disease attracting an increasing range of medical interventions and escalating healthcare costs. Changes in survival and the factors affecting survival of all patients ever diagnosed with MM in Western Australia over the past five decades and confirmed by the Western Australian Mesothelioma Registry to December 2005 were examined. Sex, age, date and method of diagnosis, site of disease and histological type were recorded. Date of onset of symptoms and performance status were obtained from clinical notes for a sample of cases. Cox regression was used to examine the association of the clinical variables and the 10-yr periods of disease onset with survival after diagnosis. Survival was inversely related to age, being worse for males (hazard ratio (HR) 1.4, 95% CI 1.2-1.6), and those with peritoneal mesothelioma (HR 1.4, 95% CI 1.1-1.7). Patients with sarcomatoid histology had worse prognosis than patients with epithelioid and biphasic histological subtypes. Survival improved after the 1970s and has made incremental improvements since then. Median (interquartile range) survival by decade, from 1960 until 2005, was 64 (0-198), 177 (48-350), 221 (97-504), 238 (108-502) and 301 (134-611) days; ~4 weeks of this apparent improvement can be attributed to earlier diagnosis. With increasing resources and treatment costs for MM over the past 40 yrs, there have been modest improvements in survival but no complete remissions. Copyright©ERS 2011. 2011 Journal Article http://hdl.handle.net/20.500.11937/20002 10.1183/09031936.00000811 unknown
spellingShingle Musk, A.
Olsen, N.
Alfonso, Helman
Reid, Alison
Mina, R.
Franklin, P.
Sleith, J.
Hammond, N.
Threlfall, T.
Shilkin, K.
De Klerk, N.
Predicting survival in malignant mesothelioma
title Predicting survival in malignant mesothelioma
title_full Predicting survival in malignant mesothelioma
title_fullStr Predicting survival in malignant mesothelioma
title_full_unstemmed Predicting survival in malignant mesothelioma
title_short Predicting survival in malignant mesothelioma
title_sort predicting survival in malignant mesothelioma
url http://hdl.handle.net/20.500.11937/20002