A new study suggests that women have a survival advantage over men when it comes to treatment for the most common type of malignant pleural mesothelioma.
Although as many as 90 percent of people who contract the asbestos-linked cancer are men, women who contract the disease in its most common form are more likely to respond well to aggressive treatment. The study published in the Annals of Thoracic Surgery reviewed 702 cases of malignant pleural mesothelioma. Of those, 145 were women.
The researchers found a definite difference in survival for men and women with one type of mesothelioma but they found no gender difference with the other type.
Among the 450 men and women with the most common histological type of mesothelioma, known as epithelioid, women tended to get the disease at a younger age and were more likely to demonstrate thrombocytosis (high blood platelet counts). But the women in the study were also more likely to survive longer after surgery than men with the same type of mesothelioma.
“The effect of gender on survival of patients with epithelial disease persisted when controlling for age, stage, thrombocytosis, leukocytosis, and anemia with a multivariable analysis, “ note the Brigham and Women’s Hospital researchers.
But the news was not as good for women with non-epithelioid (sarcomatoid or biphasic) mesothelioma. Two hundred fifty of the study’s participants fell into this category. Women who had sarcomatoid or biphasic mesothelioma – both of which are less common but more aggressive – did not differ from their male counterparts in survival.
The researchers concluded that, barring other health problems, women with epithelioid mesothelioma can tolerate, and likely benefit from, intensive treatment including surgery.
They wrote “These findings support an aggressive approach to treating MPM including extrapleural pneumonectomy in individuals with favorable prognostic predictors, particularly women with epithelial histology and no other risk factors.”
Although most cases of mesothelioma in men can be traced to occupational exposure to asbestos, many women who contract the disease are victims of second-hand exposure such as washing a spouse’s contaminated work clothes.
Wolf, AS et al. “Characteristics of Malignant Pleural Mesothelioma in Women”, September 2010, Annals of Thoracic Surgery. Pp 949-956.
Meragi-Miandoab, S et al. “Morbidity, mortality, mean survival, and the impact of histology on survival after pleurectomy in 64 patients with malignant pleural mesothelioma”, August 6, 2010. International Journal of Surgery.