Prognosis and Its Determinants in 32 Patients with Malignant Pleural Mesothelioma Treated with Palliative Care

Abstract

Objective. The number of patients with malignant pleural mesothelioma who cannot undergo active treatment due to an older age or the presence of severe comorbidities is increasing. However, studies regarding the survival status and prognostic factors in such patients are limited. We therefore documented the survival and studied important prognostic factors in patients with mesothelioma treated with palliative care. Methods. We conducted retrospective medical chart reviews of patients with a diagnosis of malignant pleural mesothelioma treated at the Respiratory Disease Center, Hyogo Prefectural Amagasaki Hospital, Japan between 2007 and 2012. Kaplan-Meier survival curves of the patients stratified according to the prognostic variables were assessed using the log-rank test. For the multivariate analysis of prognostic factors, a Cox proportional hazards model was used. Results. Thirty-two eligible patients were identified. The median survival of the entire group was 303 days. The 1-year survival rate was 35.8%. Significant factors for a poor prognosis in the univariate analysis included an advanced clinical stage and non-epithelial cell type (p<0.05). In the multivariate analysis, the prognostic significance of an advanced clinical stage was retained (hazard ratio (HR): 5.17, 95% confidence interval (CI): 1.70-15.68, p=0.004), and a non-epithelial cell type was found to be marginally significant with respect to a shorter survival period (HR: 3.01, 95%CI: 1.00-9.05, p=0.050). Conclusions. In this study, conservatively managed patients with malignant pleural mesothelioma had a median survival of approximately 10 months. An advanced clinical stage and non-epithelial cell type were found to be important prognostic factors in these patients.