Malignant pleural mesothelioma is a rare and aggressive malignancy with a dismal prognosis. A new study is predicting mesothelioma survival among male and female patients in the United States.
Identifying factors “associated with mesothelioma mortality is important research given the poor prognosis” according to Dr. Bian Liu from the a Icahn School of Medicine at Mount Sinai in New York.
A new study applied a machine-learning algorithm to 12,210 patients to predict survival. The top three factors were age, histological type, and cancer-directed surgery status.
Analyzing Over 12,000 Mesothelioma Patients
Scientists from the New York State Department of Health included 12,210 mesothelioma patients. They involved only malignant pleural mesothelioma patients. They excluded cases with unknown diagnostic confirmation and unknown survival time.
Scientists identified mesothelioma cases reported by 18 cancer registries between 2000 to 2017. They applied a mathematical algorithm to identify and rank the importance of 10 variables. They ranked variables in predicting survival overall and by female and male subgroups.
Approximately 91.4% of the mesothelioma patients had died. The participant group showed better survival among females than males (11.7% vs 7.8%). The majority of the participants were male (78.6%) and non-Hispanic White (81.8%). Most participants lived in metropolitan areas with a population greater than 1 million. At cancer diagnosis, 80% of the patients were aged 65 years and above.
This study did not include some important factors known to affect mesothelioma survival. They did not include patient comorbidities. They did not include information about other therapy (e.g., chemotherapy, radiation, or multimodal therapy).
Finding the Top Three Factors Predicting Mesothelioma Survival
The top three factors predicting mesothelioma survival were age, histological type, and surgery status.
Patient age is a top factor in predicting mesothelioma survival. Next, histological type or the type of tissue in which the cancer originates. And finally, cancer-directed surgery status including those patients where surgery was not recommended.
All 10 variables except for race/ethnicity had positive variable importance. In other words, nine variables indicated they improved the survival prediction. Race/ethnicity was not a good predictor for survival among mesothelioma patients overall.
The 9 predictors (from high to low importance) were age, histology, and surgery status. Next was diagnosis year, metastasis, and summary stage. And finally, rural-urban continuum, median household income, and sex.
The cancer stage ranked fifth in predicting female survival. Median household income was not a good predictor for survival among females.
Predicting Mesothelioma Survival in Male and Female Patients
A new study identified three factors predicting mesothelioma survival. The top three factors were age, histological type, and cancer-directed surgery status.
Increased risk in mortality came from patient increasing age. Also, having fibrous or biphasic histology subtypes. Decreased mortality risk rests in patients having epithelioid histology. Also, those patients diagnosed more recently. Cancer metastasis increased the risk of dying among all patients.
Male patients with a recommendation for surgery experienced a decreased mortality risk. This was regardless of whether surgery was performed or not. However, this same association was only significant among females if the surgery was performed.
Liu, B., Niu, L., Boscoe, F., & Lee, F. F. (2021). Predictors of Survival among Male and Female Patients with Malignant Pleural Mesothelioma: A Random Survival Forest Analysis of Data from the 2000–2017 Surveillance, Epidemiology, and End Results Program. Finding Your Dream Job is Just a Click Away, 48(3), 118. https://www.naaccr.org/wp-content/uploads/2022/01/JRM-Fall-2021-Final.pdf#page=36