The clinical and pathological features of patients with malignant pleural mesothelioma, the treatments, survival and factors affecting survival

Malignant pleural mesothelioma (MPM) is a rare disease with a poor prognosis. It has epitheloid, sarcomatoid and biphasic subtypes. Surgery, radiotherapy (RT) and/or chemotherapy are used in the treatment. The aim of this study was to determine the pathological characteristics of MPM patients, the treatment modalities, and the factors affecting survival and survival. We retrospectively analyzed the patient files and evaluated the clinical, histological and pathological features, clinical stages, performance status, laboratory findings before treatment and the treatments they received and received side effects of 75 patients who applied to our clinic due to the pathological diagnosis of MPM between 01.01.2012 and 01.02.2019. The effects on overall survival time (OS) and progression-free survival (PFS) were investigated. In our study, the female to male ratio was 1.34:1. The most common complaint was dyspnoea. The patients were most frequently diagnosed with thoracoscopic pleural biopsy. The most common pathological subtype was epithelioid type. The median age at diagnosis was 63 years. OS and PFS of the patients were found as 14.9 and 9.87 months, respectively. 89.3% of the patients received chemotherapy (chemotherapy only, chemotherapy+RT, chemotherapy+ surgery, chemotherapy+surgery+RT). Platinum based agent and pemetrexed chemotherapy regimens were applied in the first-line treatment. The most common side effect after first-line chemotherapy is thrombocytopenia. The metastasis of the disease was mostly detected in the bone. In our study, there was an inverse relation between age and OS (p=0.005), direct correlation between albumin and OS (p=0.001), and a direct correlation between albumin and PFS (p=0.001). OS (p=0.038) and PFS (p=0.035) of patients with ECOG PS<2 were found to be longer than patients with a performance score ECOG PS≥2. Patients with epithelioid type had longer OS (p=0.043) than non-epithelioid type patients. OS of patients with clinical stage II were found longer than stage IIIB (p=0.035) and stage IV (p=0.015); OS of patients with clinical stage IIIA were found longer than evre IIIB (p=0.015) and stage IV (p=0.015).