A recent study led by researchers at Harvard Medical School suggests women with pleural mesothelioma (PM) who undergo a lung-sparing surgery called intended extended pleurectomy decortication (ePD) within a multimodal setting have a longer survival rate than men receiving the same treatment.
Published in the Translational Lung Cancer Research Journal, the research calls for combining various forms of treatment – including ePD – for women with PM.
“The demonstrated outcomes should provide a new benchmark for comparison in forthcoming studies,” the researchers stated.
PM: A Potentially Deadly Diagnoses
PM is a rare tumor highly associated with past asbestos exposure. Overall median survival is 12-18 months in cases where surgery is not an option.
Traditionally, PM incidence in men has been higher than in women, possibly due to more men being employed in jobs with high levels of asbestos exposure. However, PM incidence in male patients decreased from 2000 to 2015 but remained about the same for female patients, according to the Harvard study.
Study: 28.2% of Women Achieved 5-Year Survival
The study analyzed outcomes for patients who underwent intended ePD for PM along with other forms of treatment from 2007-2017 at the Division of Thoracic Surgery at Brigham and Women’s Hospital in Boston. During that period, 454 individuals – including 114 women – had the lung-sparing surgery.
The analysis revealed the median time from surgery to disease progression or death, whichever came first, was 455 days for women compared to 310 for men. The median relapse-free survival for female patients was 468 days versus 323 for males.
The researchers noted that a lower survival rate for men “is not unique to PM and seen in other malignancies such as anorectal, melanoma, salivary gland, thyroid cancer, and more.”
The women also had low 30-day and 90-day mortality rates following surgery, at 3.5% and 6.1%, respectively, according to the study. The median survival for the group was 38 months, with 28.2% achieving 5-year survival.
What Makes the Study Unique
The study differs from previous ones on this topic because it involves an analysis of a large group of patients treated at a single institution rather than various medical centers.
The findings “may not be generalizable and vary in other institutions,” the researchers stated. “However, this may be a strength of the present study because it ensures a more consistent approach to the surgical procedure, follow-up, and management compared with retrospective multi-institutional studies.”
