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V.C. Cordeiro De Lima



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    P2.09 - Mesothelioma (ID 710)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Mesothelioma
    • Presentations: 1
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      P2.09-002 - Prevalence and Survival of Malignant Pleural Mesothelioma Patients Treated in a Single Brazilian Cancer Center (ID 9942)

      09:30 - 09:30  |  Presenting Author(s): V.C. Cordeiro De Lima

      • Abstract
      • Slides

      Background:
      Malignant pleural mesothelioma (MPM) is an unusual neoplasm, originated from the mesothelial surface of the pleural cavity. The disease is associated with occupational exposure to asbestos. Although it has low incidence, it carries an elevated morbimortality, determined by its aggressiveness and aggravated by the lack of efficient therapeutic strategies. Most patients are diagnosed at advanced stages and median overall survival (OS) remains around 9-17 months. In Brazil, some studies have suggested the number of new cases will increase till 2030, nevertheless there is no official epidemiologic data available.

      Method:
      Clinicopathological data from patients diagnosed with MPM and treated at A.C.Camargo Cancer Center between January/2000 and December/2014 were retrospectively collected from medical records. Demographics and clinicopathological variables were described using descriptive statistics. OS was calculated from the date of diagnosis to death. Progression-free survival (PFS) was calculated from the date of diagnosis to the date of disease progression or death. Kaplan–Meier method was used to calculate survival curves. The impact of relevant variables on survival was evaluated by the log-rank test.

      Result:
      We identified 29 patients between 2000 and 2014. Median follow-up was 108 months. Median age at diagnosis was 68 years (43-85y). 72.4% was men and most were Caucasian (51.7%). Tobacco consumption reported (58.6%), history of asbestos exposure (44.8%) and positive family history of cancer (34.5%). The presenting symptom was dyspnea (44.8%); followed by chest pain (24.1%). Epithelioid subtype was reported (69%) and most patients were diagnosed in stage III (34,5%) and IV (24.1%). 79% of patients were submitted to surgery: pleural decortication (36,4%), pleurodesis (31,8%), and pleuro-pneumonectomy+mediastinal lymphadenectomy (31,8%). Chemotherapy was administered to 72.4% and radiotherapy to 24.1%. Median PFS was 8 months (95%CI 5.4-10.5) and the only factor associated with improved PFS was disease resectability (resectable vs. unresectable: 10mo vs. 7mo; p=0.041). Median OS was 12 months (95%CI 5.6-18.3). Variables associated with improved OS were lack of distant metastasis at diagnosis (M0 vs. M1-MX: 15mo vs. 6mo; p=0.008) and being able to receive further lines of chemotherapy (yes vs. no: 18mo vs. 6mo; p=0.016).

      Conclusion:
      Since there is no national official data in Brazil, collection of local data is extremely relevant to help unraveling the epidemiological scenario in our country. Our data reinforce the low prevalence of the disease, though it could also reflect issues regarding patient referral to specialized centers. As expected, we observed an association with occupational exposure to asbestos and a poor PFS and OS.

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