Comparison of outcomes following a cytological or histological diagnosis of malignant mesothelioma

Background: Survival with the epithelioid subtype of malignant mesothelioma (MM) is longer than the biphasic or sarcomatoid subtypes. There is concern that cytology-diagnosed epithelioid MM may underdiagnose the biphasic subtype. This study examines survival differences between patients with epithel...

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Main Authors: Muruganandan, S., Alfonso, Helman, Franklin, P., Shilkin, K., Segal, A., Olsen, N., Reid, Alison, de Klerk, N., Musk, A., Brims, F.
Format: Journal Article
Published: Nature Publishing Group 2017
Online Access:http://hdl.handle.net/20.500.11937/50395
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author Muruganandan, S.
Alfonso, Helman
Franklin, P.
Shilkin, K.
Segal, A.
Olsen, N.
Reid, Alison
de Klerk, N.
Musk, A.
Brims, F.
author_facet Muruganandan, S.
Alfonso, Helman
Franklin, P.
Shilkin, K.
Segal, A.
Olsen, N.
Reid, Alison
de Klerk, N.
Musk, A.
Brims, F.
author_sort Muruganandan, S.
building Curtin Institutional Repository
collection Online Access
description Background: Survival with the epithelioid subtype of malignant mesothelioma (MM) is longer than the biphasic or sarcomatoid subtypes. There is concern that cytology-diagnosed epithelioid MM may underdiagnose the biphasic subtype. This study examines survival differences between patients with epithelioid MM diagnosed by cytology only and other subtypes diagnosed by histology. Methods: Demographics, diagnosis method, MM subtype and survival were extracted from the Western Australia (WA) Mesothelioma Registry, which records details of all MM cases occurring in WA. Results: A total of 2024 MM cases were identified over 42 years. One thousand seven hundred forty-four (86.2%) were male, median (IQR) age was 68.6 (60.4–77.0) years. A total of 1212 (59.9%) cases were identified as epithelioid subtype of which 499 (41.2%) were diagnosed using fluid cytology only. Those with a cytology-only diagnosis were older than the histology group (median 70.2 vs 67.6 years, P<0.001), but median survival was similar (cytology 10.6 (5.5–19.2) vs histology 11.1 (4.8–19.8) months, P=0.727) and Cox regression modelling adjusting for age, sex, site and time since first exposure showed no difference in survival between the different diagnostic approaches. Conclusions: Survival of cytologically and histologically diagnosed epithelioid MM cases does not differ. A diagnostic tap should be considered adequate to diagnose epithelioid MM without need for further invasive testing.
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spelling curtin-20.500.11937-503952017-09-13T15:48:50Z Comparison of outcomes following a cytological or histological diagnosis of malignant mesothelioma Muruganandan, S. Alfonso, Helman Franklin, P. Shilkin, K. Segal, A. Olsen, N. Reid, Alison de Klerk, N. Musk, A. Brims, F. Background: Survival with the epithelioid subtype of malignant mesothelioma (MM) is longer than the biphasic or sarcomatoid subtypes. There is concern that cytology-diagnosed epithelioid MM may underdiagnose the biphasic subtype. This study examines survival differences between patients with epithelioid MM diagnosed by cytology only and other subtypes diagnosed by histology. Methods: Demographics, diagnosis method, MM subtype and survival were extracted from the Western Australia (WA) Mesothelioma Registry, which records details of all MM cases occurring in WA. Results: A total of 2024 MM cases were identified over 42 years. One thousand seven hundred forty-four (86.2%) were male, median (IQR) age was 68.6 (60.4–77.0) years. A total of 1212 (59.9%) cases were identified as epithelioid subtype of which 499 (41.2%) were diagnosed using fluid cytology only. Those with a cytology-only diagnosis were older than the histology group (median 70.2 vs 67.6 years, P<0.001), but median survival was similar (cytology 10.6 (5.5–19.2) vs histology 11.1 (4.8–19.8) months, P=0.727) and Cox regression modelling adjusting for age, sex, site and time since first exposure showed no difference in survival between the different diagnostic approaches. Conclusions: Survival of cytologically and histologically diagnosed epithelioid MM cases does not differ. A diagnostic tap should be considered adequate to diagnose epithelioid MM without need for further invasive testing. 2017 Journal Article http://hdl.handle.net/20.500.11937/50395 10.1038/bjc.2017.20 http://creativecommons.org/licenses/by-nc-sa/4.0/ Nature Publishing Group fulltext
spellingShingle Muruganandan, S.
Alfonso, Helman
Franklin, P.
Shilkin, K.
Segal, A.
Olsen, N.
Reid, Alison
de Klerk, N.
Musk, A.
Brims, F.
Comparison of outcomes following a cytological or histological diagnosis of malignant mesothelioma
title Comparison of outcomes following a cytological or histological diagnosis of malignant mesothelioma
title_full Comparison of outcomes following a cytological or histological diagnosis of malignant mesothelioma
title_fullStr Comparison of outcomes following a cytological or histological diagnosis of malignant mesothelioma
title_full_unstemmed Comparison of outcomes following a cytological or histological diagnosis of malignant mesothelioma
title_short Comparison of outcomes following a cytological or histological diagnosis of malignant mesothelioma
title_sort comparison of outcomes following a cytological or histological diagnosis of malignant mesothelioma
url http://hdl.handle.net/20.500.11937/50395