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  P2.06 - Mesothelioma (Not CME Accredited Session) (ID 955)

  • Event: WCLC 2018
  • Type: Poster Viewing in the Exhibit Hall
  • Track:
  • Presentations: 1
  • Moderators:
  • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall

  • 27023

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    P2.06-14 - Does Size Matter? A Population-Based Analysis of Malignant Pleural Mesothelioma (ID 11750)

    16:45 - 18:00  |  Author(s): Jianfei Shen
    • Abstract
    • Slides

    Background
    

    The malignant pleural mesothelioma (MPM) is a rare and aggressive malignancies. A validated staging system is crucial for disease evaluation, treatment selection and follow-up strategy. The 8^th edition staging system for MPM has been recently proposed. However, it has not been widely accepted due to the absence of validation of large cohort. Besides, the size of tumor is not taken into consideration. We intend to elucidate the prognostic value of the size of MPM and evaluate the current staging system via the data of SEER database.

    a9ded1e5ce5d75814730bb4caaf49419 Method
    

    All cases of primary MPM were identified and extracted from the SEER database during the period of 1973-2013. Kaplan-Meier method was used to analyzed overall survival and cancer-specific survival. The prognostic factors were identified by Cox regression. LOWESS smoothing regression curve was also utilized. The cut-off points of size in different strata were identified based on the graphical characteristics. The tumor stage was established incorporating tumor extension and size. The adjusted clinical staging system was proposed and compared with the previous MPM staging system by likelihood ratio test.

    4c3880bb027f159e801041b1021e88e8 Result
    

    A total of 2138 patients were included. The 1,3 and 5-year survival rates of MPM were 39.4%, 11.8% and 3.8%. Tumor extension, lymph node involvement and metastasis, tumor size, histology and differentiatial grade were significant prognostic factors. Radical surgery and local destruction might have the similar effect in early stage patients. Triple combination treatments showed a superiority to others. The cut-off points of tumor size were ≤3cm and >7cm. The adjusted staging system was proved to be more accurate.

    

    8eea62084ca7e541d918e823422bd82e Conclusion
    

    Tumor size matters in the prognosis of MPM especially in early stages. The adjusted TNM staging system incorporating tumor size has better accuracy than the 8^th edition. However, some stages had not been fully verified. More cases of early stages are warranted for essential revision.

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