Factors influencing malignant mesothelioma survival: a retrospective review of the National Mesothelioma Virtual Bank cohort.
Factors influencing malignant mesothelioma survival: a retrospective review of the National Mesothelioma Virtual Bank cohort.
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DOI：
10.12688/f1000research.15512.2
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发表时间：
2018-01-01
期刊：
影响因子：
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通讯作者：
Becich, Michael J
中科院分区：
文献类型：
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作者：
Amin, Waqas;Linkov, Faina;Becich, Michael J
背景：恶性间皮瘤（MM）是一种罕见但致命的恶性肿瘤，在美国每年约有3000例新病例被诊断出来。很少有研究分析间皮瘤生存的相关因素，特别是腹膜表现。本研究的主要目的是检查在国家间皮瘤虚拟银行（NMVB）登记的恶性间皮瘤患者队列的生存率。方法：从NMVB数据库中选择1990 - 2017年诊断的胸膜和腹膜间皮瘤病例888例，其中1400余例。Kaplan Meier法进行生存分析。采用Cox风险回归法估计预后因素与生存率的相关性，并使用R软件进行分析。结果：所有MM患者（包括胸膜和腹膜间皮瘤）的中位总生存期（OS）为15个月（胸膜间皮瘤14个月，腹膜间皮瘤31个月）。在这个NMVB队列中，与恶性间皮瘤患者生存率提高相关的重要预后因素是年龄小于45岁，女性，上皮样组织学亚型，I期，腹膜发生，并接受手术与化疗联合治疗。与单线治疗相比，手术和化疗联合治疗可延长23个月的生存期。结论：多年来，在现有的治疗方案下，恶性间皮瘤患者的总生存率并未得到改善。我们的研究结果表明，腹膜间皮瘤的手术和化疗联合治疗与单独局部治疗相比可提高生存率。
Background: Malignant mesothelioma (MM) is a rare but deadly malignancy with about 3,000 new cases being diagnosed each year in the US. Very few studies have been performed to analyze factors associated with mesothelioma survival, especially for peritoneal presentation. The overarching aim of this study is to examine survival of the cohort of patients with malignant mesothelioma enrolled in the National Mesothelioma Virtual Bank (NMVB). Methods: 888 cases of pleural and peritoneal mesothelioma cases were selected from the NMVB database, which houses over 1400 cases that were diagnosed from 1990 to 2017. Kaplan Meier's method was performed for survival analysis. The association between prognostic factors and survival was estimated using Cox Hazard Regression method and using R software for analysis. Results: The median overall survival (OS) rate of all MM patients, including pleural and peritoneal mesothelioma cases is 15 months (14 months for pleural and 31 months for peritoneal). Significant prognostic factors associated with improved survival of malignant mesothelioma cases in this NMVB cohort were below the age of 45, female gender, epithelioid histological subtype, stage I, peritoneal occurrence, and had treatment that consisted of combining surgical therapy with chemotherapy. Combined surgical and chemotherapy treatment was associated with improved survival of 23 months in comparison to single line therapies. Conclusions: There has not been improvement in the overall survival for patients with malignant mesothelioma over many years with current available treatment options. Our findings show that combined surgical and chemotherapy treatment in peritoneal mesothelioma is associated with improved survival compared to local therapy alone.