Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jun 10;40(4):529-536.
doi: 10.1093/carcin/bgz004.

Prognostic factors of survival in patients with malignant pleural mesothelioma: an analysis of the National Cancer Database

Maaike Van Gerwen  1 , Naomi Alpert  1 , Andrea Wolf  2 , Nisha Ohri  3 , Erik Lewis  2 , Kenneth E Rosenzweig  4 , Raja Flores  2   5 , Emanuela Taioli  1   2   5
Affiliations

Prognostic factors of survival in patients with malignant pleural mesothelioma: an analysis of the National Cancer Database

Maaike Van Gerwen et al. Carcinogenesis. .

Abstract

Malignant pleural mesothelioma (MPM) is a rare disease with a very poor prognosis. Previous studies have indicated that women experience longer survival compared with men. We analyzed 16 267 eligible patients (21.3% females) in the National Cancer Database to evaluate which clinical factors are independently predictive of longer survival. After adjusting for all covariates, survival was significantly better in females compared with males [HRadj: 0.81, 95% confidence interval (CI): 0.77-0.85]. Other factors significantly associated with better survival were younger age at diagnosis, higher income, lower comorbidity score, epithelial histology, earlier stage and receipt of surgical or medical treatment. After propensity matching, survival was significantly better for females compared with males [hazard ratio (HR): 0.86, 95% CI: 0.80-0.94]. After propensity matching within the epithelial group, survival remained significantly better for females compared with males (HR: 0.85, 95% CI: 0.74-0.97). This study adds information to the known significant gender survival difference in MPM by disentangling the effect of gender from the effect of age and histology, two known independent factors affecting survival. Circulating estrogen, present in young but not older women, and higher expression of the estrogen receptor beta in epithelial mesothelioma have been suggested to play a role in gender survival differences. These findings may lead to exploring new therapeutic options, such as targeting estrogen receptor beta, and considering hormonal therapy including estrogens for patients with otherwise limited prognosis.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Selection criteria.
Figure 2.
Figure 2.
Overall survival according to gender in (A) propensity-matched cohort (n = 4748); (B) <50 years (n = 140); (C) ≥50 years (n = 4580).
Figure 3.
Figure 3.
Overall survival in epithelia histology cases (propensity-matched cohort) according to gender (n = 1890).
See this image and copyright information in PMC

References

    1. Yang H., et al. (2008) Mesothelioma epidemiology, carcinogenesis, and pathogenesis. Curr. Treat. Options Oncol., 9, 147–157. - PMC - PubMed
    1. Flores R.M., et al. (2010) Frequency of use and predictors of cancer-directed surgery in the management of malignant pleural mesothelioma in a community-based (Surveillance, Epidemiology, and End Results [SEER]) population. J. Thorac. Oncol., 5, 1649–1654. - PubMed
    1. Spirtas R., et al. (1988) Survival patterns for malignant mesothelioma: the SEER experience. Int. J. Cancer., 41, 525–530. - PubMed
    1. Milano M.T., et al. (2010) Malignant pleural mesothelioma: a population-based study of survival. J. Thorac. Oncol., 5, 1841–1848. - PubMed
    1. Taioli E., et al. (2014) Women with malignant pleural mesothelioma have a threefold better survival rate than men. Ann. Thorac. Surg., 98, 1020–1024. - PubMed

Publication types

MeSH terms