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Guillermo Martinez



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    P2.06 - Mesothelioma (ID 170)

    • Event: WCLC 2019
    • Type: Poster Viewing in the Exhibit Hall
    • Track: Mesothelioma
    • Presentations: 1
    • Now Available
    • Moderators:
    • Coordinates: 9/09/2019, 10:15 - 18:15, Exhibit Hall
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      P2.06-24 - Mesothelioma Survival in 2 Health Centres in Santiago de Chile (Now Available) (ID 2077)

      10:15 - 18:15  |  Author(s): Guillermo Martinez

      • Abstract
      • Slides

      Background

      Malignant pleural mesothelioma (MPM) is a rare but lethal tumour arising in the 5th – 7th decade of life of predominantly male industrial workers of developed countries. The prognosis is dismal because of early spreading and scarcity of therapies. Surgery (extrapleural pneumonectomy or pleurectomy/decortication) has shown some improvement in patient survival, even more important with the addition of radio or chemotherapy. Patients unfit or with advanced disease are treated with palliative chemotherapy or palliative care alone. Some centres (or countries) doesn’t have the resources to embark in such aggressive and expensive managements, pondering the idea that in mesothelioma patients, complex therapies are only a futility exercise not worth the investment in herculean surgery or costly and patient-consuming radio or chemotherapy. The question if aggressive therapy is superior to nihilist approaches in terms of survival (SV) is difficult to answer but of critical importance in developing countries

      Method

      Consecutive patients pathologically diagnosed with MPM of 2 health centres in the same city and time frame were assessed. Centre A is a public Hospital with an assigned population of 1 million, without thoracic surgeon and oncologic committee, and patients were seldom referred to palliative chemotherapy. Centre B is a terciary, referral academic university Hospital with Thoracic surgeons and oncologic committee. Centre A had 10 patients reviewed and centre B 20. Both cohorts were examined in terms of treatment and SV

      Result

      The 2 series were comparable in terms of age (median=61,5) and sex (masculine: 70% for Centre A, 80% for Centre B). Centre A had 30% of patients with presence of metastasis at the time of diagnosis, while centre B had 10%. In centre A 2 of 10 patients received chemotherapy. In centre B: 9 patients had aggressive surgery, 7 patients received chemotherapy and 2 patients received radiotherapy. Kaplan Meier estimate showed 12-month SV of 51% (CI95% 16-79) in centre A and 59% (CI95% 35-77) in centre B, but there were no statistical differences between both groups

      Conclusion

      Few patients were diagnosed (30 overall) in line with chilean epidemiology. The 2 centres had radically different resources and approaches to treat this illness, however, even though there is a tendency towards better survival in Centre B, there were no statistically differences between both groups. Differences could appear increasing the follow-up time or including more centres, alternatively, the rarity of this disease could produce oncologic teams with not enough experience dealing with it affecting survival outcomes.

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