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Monica Malec

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    P2.06 - Mesothelioma (ID 170)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Mesothelioma
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.06-12 - Dysphagia in Patients with Malignant Pleural Mesothelioma (MPM) (ID 2896)

      10:15 - 18:15  |  Presenting Author(s): Monica Malec

      • Abstract


      Dysphagia is common with advanced malignancies but is not well characterized in MPM and is under-recognized as a symptom attributable to this disease. The prevalence of dysphagia in MPM is unknown. Available literature is limited to a few case reports. Dysphagia can lead to nutritional compromise, pain and deterioration of quality of life. It can occur as a result of extrinsic compression of the esophagus by mediastinal lymphadenopathy, intrinsic mechanical obstruction or pseudo-achalasia secondary to infiltration of the esophagus. Palliation is an important goal of therapy and recognizing the underlying etiology will guide selection of interventions.


      We performed a single center, retrospective cohort study of MPM patients who reported dysphagia treated at the University of Chicago between 6/1/2016 and 4/1/2018. 250 consecutive patient records were reviewed for the report of dysphagia and chart extraction was performed. Patient factors collected included patient age at diagnosis, gender and comorbid medical illness. Mesothelioma specific factors included tumor histology, treatment history and overall survival. Dysphagia specific factors including onset of dysphagia relative to diagnosis and patient death, characteristics of dysphagia, findings on imaging and evaluation and interventions performed.


      Eleven patients (4.4%) reported dysphagia. Median age was 72 (range 55-88). 100% male. 8 had right sided, 3 had left sided disease. Tumor histology: 6 epithelioid, 1 sarcomatoid and 4 biphasic. Of these, one patient had dysphagia unrelated to mesothelioma that resolved with surgical intervention. Of the remaining 10 patients, 9 had mediastinal adenopathy and/or esophageal involvement on CT scans. 1 patient had no CT findings to explain dysphagia and EGD revealed extrinsic compression. 3 patients were stented. 2 of 3 required repeat procedures. 1 required a feeding tube. Median time from diagnosis to onset of dysphagia was 18 months (range 0.7-31.7) One patient developed dysphagia 2 months prior to diagnosis. Median time from development of dysphagia to death was 5.7 months ( range 2-7.7) One patient remains alive. Median overall survival was 19.8 months (range 4.4-159.7).


      Dysphagia in patients with malignant pleural mesothelioma is most often attributable to the underlying malignancy due to extrinsic compression from mediastinal adenopathy or direct tumor extension. This development is a poor prognostic sign and, in this sample, signaled a median survival just under 6 months. Patients with the shortest interval from diagnosis to onset of dysphagia had the shortest overall survival. A prospective study to further characterize dysphagia in MPM and optimize interventions is ongoing.

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    WS02 - Mesothelioma Workshop (Ticketed Session) (ID 102)

    • Event: WCLC 2019
    • Type: Workshop
    • Track: Mesothelioma
    • Presentations: 1
    • Now Available
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      WS02.07 - Palliative Care in MPM (Now Available) (ID 3836)

      08:00 - 11:30  |  Presenting Author(s): Monica Malec

      • Abstract
      • Presentation
      • Slides

      Abstract not provided

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