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Title:Improved survival after introduction of chemotherapy for malignant pleural mesothelioma in Slovenia : population-based survey of 444 patients
Authors:ID Kovač, Viljem (Author)
ID Zwitter, Matjaž (Author)
ID Žagar, Tina (Author)
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MD5: 8A28FA319B3B83A17DA300BAD189376B
 
Language:English
Typology:1.01 - Original Scientific Article
Organization:Logo OI - Institute of Oncology
Abstract: Background. Malignant pleural mesothelioma is a rare tumour with increasing frequency throughout the world. Due to long latency after exposure to asbestos, restrictions in the production and use of asbestos have not yet alleviated the burden of mesothelioma. During the last decade, several trials confirmed the benefit of systemic treatment with drugs such as doublets with cisplatina and gemcitabine or pemetrexed for carefully selected patients in good performance status. The purpose of this survey was to assess the impact of systemic treatment for the whole national population of patients with mesothelioma. Patients and methods. A retrospective study included all patients in Slovenia with histologically confirmed diagnosis of malignant pleural mesothelioma in the period from 1974 till 2008. Data from the Cancer Registry of Slovenia were supplemented by review of clinical records of the Institute of Oncology in Ljubljana where virtually all non-surgical treatment for mesothelioma was performed. We analysed the incidence, treatment, and survival of patients treated in the era of infrequent chemotherapy (1974-2003,the first period) and after it (2004-2008, the second period). Results. The survey included 444 patients, of whom 325 and 119 were diagnosed in the first and second period, respectively. Joinpoint regression analysis showed that after 1995 the trend in crude incidence rates increased more rapidly; the annual change was 0.03 per 100,000 per year before 1995 and 0.06 per 100,000 per year after. There was clear male predominance (70%) throughout the period covered by the survey. The proportion of patients above 65 years of age increased from 41.8% to 54.6% for the first and second period, respectively (p = 0.02). With a total of 52 (11.7%) operated patients, surgical treatment was rare and used only for selected patients with early disease and without comorbidity, leading to their relatively long median survival of 13.6 months. Chemotherapy was applied to 56 (17.2%) and to 96 (80.7%) patients during the first and second period, respectively. While a variety of older drugs were used in the first period, the most common regimen in the second period (applied to 91 patients) was doublet of low-dose gemcitabine in prolonged infusion and cisplatin. For the whole population of patients regardless the mode of treatment, median survival was 7.4 and 12.6 months (p-value = 0.037) for the first and second period, respectively. Conclusions. Increasing incidence, male predominance and increased proportion of older patients confirm that the burden of mesothelioma persists in spite o fa 15-years old ban in the production of asbestos. Modern chemotherapy, and in particular treatment with low-dose gemcitabine in prolonged infusion and cisplatin significantly prolonged median survival of patients with malignant pleural mesothelioma in Slovenia.
Publication status:Published
Publication version:Version of Record
Publication date:01.06.2012
Publisher:Association of Radiology and Oncology
Year of publishing:2012
Number of pages:str. 136-144, IV
Numbering:Vol. 46, no. 2
Source:Ljubljana
PID:20.500.12556/DiRROS-18495 New window
UDC:616.24-006.6-03
ISSN on article:1318-2099
DOI:10.2478/v10019-012-0032-0 New window
COBISS.SI-ID:1310843 New window
Copyright:by Authors
Publication date in DiRROS:21.03.2024
Views:197
Downloads:54
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Record is a part of a journal

Title:Radiology and oncology
Shortened title:Radiol. oncol.
Publisher:Slovenian Medical Society - Section of Radiology, Croatian Medical Association - Croatian Society of Radiology
ISSN:1318-2099
COBISS.SI-ID:32649472 New window

Secondary language

Language:Slovenian
Title:Izboljšanje preživetja po uvedbi kemoterapije pri bolnikih z malignim plevralnim mezoteliomom v Sloveniji
Keywords:pljučni rak, mezoteliom, kemoterapija, onkologija


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