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Abstract
Background. There are few reports concerning treatment strategies and their contributions to survival of patients with malignant mesothelioma (MM) in Japan. Material and methods. We extracted all death cases due to MM between 2003 and 2008. The diagnosis of MM was confirmed in 929 cases. Histological subtypes was determined in 709 cases, including 396 (55.9%) epithelioid, 154 (21.7%) sarcomatoid, 126 (17.8%) biphasic, and 33 (4.7%) other types. Results and conclusion. Median overall survival (OS) of all MM cases was 7.7 months (95% confidence interval, 7.1–8.3). Median OS of patients with epithelioid MM was significantly longer than that of patients with biphasic (p = 0.030) or sarcomatoid (p < 0.001) MM. Surgical resection was performed in 172 patients (18.5%) and 449 (48.3%) received systemic chemotherapy. Survival of patients treated with both surgery and systemic chemotherapy was favorable. Median OS of patients in the late phase of the study period (2006–2008) was significantly longer than that in the early phase (2003–2005) (8.1 vs. 7.5 months, p = 0.008). Independent favorable prognostic factors included age younger than 70 years, female gender, epithelioid subtype, and clinical stage I–III. Multivariate analysis demonstrated that patients who had radical surgery and systemic chemotherapy showed a longer survival, though this could be due to selection bias of patients.
Acknowledgements
This research is mainly due to the research foundation from the Ministry of Health, Labour and Welfare of Japan, 200500129A, 200635021A, 200733015A, 200733015B, 200836010A, 200938007A, and 201032004B. It is a part of the research and development and dissemination projects related to the 13 fields of occupational injuries and illnesses of the Japan Labour, Health and Welfare Organization. The sponsors had no involvement in the study design, collection, analysis and interpretation of the data, writing of the manuscript, or decision to submit the manuscript for publication. The authors would like to thank the living relatives of mesothelioma patients who gave consent to our research, the medical institutions that provided the medical information for the mesothelioma cases and Mrs. Rie Sugimoto, Mrs. Keiko Fujimura, and Miss Naomi Ogura for collecting data.
Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.