A new study conducted in Australia contains some good news and some bad news for people with malignant pleural mesothelioma and their loved ones. The findings indicate that it is possible to survive longer with pleural mesothelioma, but survival may not have as much to do with specific treatments as scientists have thought.
The study focused on 910 patients from New South Wales, Australia, an area with a rich history of asbestos mining. Patients were all registered with the New South Wales Dust Diseases board between 2002 and 2009. Researchers from the Asbestos Diseases Research Institute and Sydney Medical School used the database to compile a list of prognostic factors that appear to impact mesothelioma survival.
Ninety percent of study subjects were men and 60 percent had the epithelioid type of mesothelioma. The group was about equally divided between those in the earlier stages of mesothelioma (stages I-II) and those in the advanced stages (stages III-IV). Chemotherapy was administered in 44 percent of cases and 6 percent of patients underwent radical mesothelioma surgery called extrapleural pneumonectomy (EPP).
The median overall survival for all mesothelioma patients in the analysis was 10 months, but nearly a quarter of patients survived for more than twice that long. The study confirmed what other studies have found regarding mesothelioma survival – that younger people (under 70), women, those with epithelioid histology, lower neutrophil/lymphocyte ratio (under 5), and normal hemoglobin had the best outcomes.
But the study results were not entirely predictable. While patients undergoing extrapleural pneumonectomy or pemetrexed-based chemotherapy demonstrated better survival than those who did not have these treatments, a portion of the longest mesothelioma survivors in the study had neither of these. Eighty-four percent of long survivors did not have EPP and 34 percent did not even have chemotherapy.
Although most mesothelioma patients do not survive more than about a year beyond diagnosis, there are cases, such as that of Paul Kraus, the longest-living mesothelioma survivor, where people have lived for many years. Scientists continue to try to determine the exact combination of prognostic factors and treatment protocols that improve the mesothelioma survival odds.
Linton, A et al, “Factors associated with survival in a large series of patients with malignant pleural mesothelioma in New South Wales”, September 4, 2014, British Journal of Cancer, Epub ahead of print