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. 2023 Sep;18(9):1233-1247.
doi: 10.1016/j.jtho.2023.06.011. Epub 2023 Jun 23.

European Epidemiology of Pleural Mesothelioma-Real-Life Data From a Joint Analysis of the Mesoscape Database of the European Thoracic Oncology Platform and the European Society of Thoracic Surgery Mesothelioma Database

Isabelle Opitz  1 , Andrea Bille  2 , Urania Dafni  3 , Kristiaan Nackaerts  4 , Luca Ampollini  5 , Marc de Perrot  6 , Luka Brcic  7 , Ernest Nadal  8 , Konstantinos Syrigos  9 , Steven G Gray  10 , Joachim Aerts  11 , Alessandra Curioni-Fontecedro  12 , Jan H Rüschoff  13 , Kim Monkhorst  14 , Birgit Weynand  15 , Enrico Maria Silini  16 , Fatemeh Bavaghar-Zaeimi  6 , Marko Jakopovic  17 , Roger Llatjos  18 , Sotirios Tsimpoukis  9 , Stephen P Finn  19 , Jan von der Thüsen  20 , Nesa Marti  21 , Georgia Dimopoulou  22 , Roswitha Kammler  21 , Solange Peters  23 , Rolf A Stahel  24 , Pierre-Emmanuel Falcoz  25 , Alessandro Brunelli  26 , Paul Baas  27 ; ETOP Mesoscape and ESTS Consortia
Collaborators, Affiliations
Free article

European Epidemiology of Pleural Mesothelioma-Real-Life Data From a Joint Analysis of the Mesoscape Database of the European Thoracic Oncology Platform and the European Society of Thoracic Surgery Mesothelioma Database

Isabelle Opitz et al. J Thorac Oncol. 2023 Sep.
Free article

Abstract

Introduction: Pleural mesothelioma (PM) is an aggressive malignancy with increasing prevalence and poor prognosis. Real-life data are a unique approach to reflect the reality of PM epidemiology, treatment, and prognosis in Europe.

Methods: A joint analysis of the European Thoracic Oncology Platform Mesoscape and the European Society of Thoracic Surgeons (ESTS) databases was performed to better understand the characteristics and epidemiology of PM, including histologic subtype, staging, and treatment. Overall survival (OS) was assessed, adjusting for parameters of clinical interest.

Results: The analysis included 2766 patients (Mesoscape: 497/10 centers/ESTS: 2269/77 centers). The primary histologic subtype was epithelioid (71%), with 57% patients on stages III to IV. Within Mesoscape, the patients received either multimodality (59%) or palliative intention treatment (41%). The median follow-up was 47.2 months, on the basis of 1103 patients (Mesoscape: 491/ESTS: 612), with 823 deaths, and median OS was 17.4 months. In multivariable analysis, female sex, epithelioid subtype, and lower stage were associated with longer OS, when stratifying by cohort, age, and Eastern Cooperative Oncology Group Performance Status. Within Mesoscape, multimodality treatment including surgery was predictive of longer OS (hazard ratio = 0.56, 95% confidence interval: 0.45-0.69), adjusting for sex, histologic subtype, and Eastern Cooperative Oncology Group Performance Status. Overall, surgical candidates with a macroscopic complete resection had a significantly longer median OS compared with patients with R2 (25.2 m versus 16.4 m; log-rank p < 0.001).

Conclusions: This combined European Thoracic Oncology Platform/ESTS database analysis offers one of the largest databases with detailed clinical and pathologic outcome. Our finding reflects a benefit for selected patients that undergo multimodality treatment, including macroscopic complete resection, and represents a valuable resource to inform the epidemiology and treatment options for individual patients.

Keywords: Epidemiology; MCR; Multimodality treatment; Pleural mesothelioma; Real-world data; Registry.

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