Survival formesothelioma has been shown to be poor, withmarginal improvement over time. Recent advances in the understanding of pathophysiology and treatment of mesothelioma may impact therapy to improve survival that may not be evident from available clinical trials that are often small and not randomized. Therapies may affect survival differently based onmesothelioma location (pleural vs peritoneal). Data are conflicting regarding the effect of asbestos exposure on mesothelioma location. OBJECTIVES: We examined survival in a large cohort of mesothelioma subjects analyzed by tumor location and presence andmode of asbestos exposure.METHODS: Data were analyzed fromcases (n = 380) diagnosed with mesothelioma from 1992 to 2012. Cases were either drawn from treatment referrals, independent medical evaluation for medical legal purposes, or volunteers who were diagnosed with mesothelioma. Subjects completed an occupational medical questionnaire, personal interview with the examining physician, and physician review of the medical record. RESULTS: This study reports better survival for mesothelioma than historical reports. Survival for peritonealmesothelioma was longer than that for pleural mesothelioma (hazard ratio=0.36, 95% confidence interval=0.24-0.54, P<.001) after adjusting for gender and age at diagnosis.Non-occupational caseswere more likely to be 1) diagnosedwith peritonealmesothelioma, 2) female, 3) exposed, and 4) diagnosed at a younger age and to have a 5) shorter latency compared to occupational cases (P <.001). CONCLUSION: Peritoneal mesothelioma was more likely associated with non-occupational exposure, thus emphasizing the importance of exposure history in enhancing early diagnosis and treatment impact.
Faig, J., Howard, S., Levine, E. A., Casselman, G., Hesdorffer, M., & Ohar, J. A. (2015). Changing pattern in malignant mesothelioma survival. Translational Oncology, 8(1), 35–39. https://doi.org/10.1016/j.tranon.2014.12.002