PROGNOSTIC FACTORS AND SURVIVAL IN MALIGNANT PLEURAL MESOTHELIOMA

Malignant pleura mesothelioma is a lethal disease and little is known about prognostic factors. The prognostic significance of age, stage of disease, gender and histological subtype was studied in 167 new cases of cytologically (15%) or histologically (85%) proven malignant pleur al mesothelioma in the Rotterdam area, during the period 1987-1989. Me dian survival of all patients was 242 days. Univariate analysis identi fied age, stage and histopathological subtype as significant prognosti c factors, which was confirmed in multivariate analysis. Median surviv al rates for patients <65, 65-74 and greater-than-or-equal-to 75 yrs w ere 359, 242 and 131 days, respectively. Patients with Stage I disease had a median survival of 359 days compared to 147 and 112 days, respe ctively, for patients with Stage II and the combination of Stages III and IV. Mixed histopathological subtype (190 days) was less favourable than sarcomatous (207 days) and epithelial (252 days) subtypes. Using a Cox proportional hazard model in patients with malignant pleural me sothelioma, age, histological subtype and stage were identified as ind ependent prognostic factors. These prognostic factors should be taken into account when starting or evaluating treatment studies.