Initial analysis of the international association for the study of lung cancer mesothelioma database

Valerie W. Rusch, Dorothy Giroux, Catherine Kennedy, Enrico Ruffini, Ayten K. Cangir, David Rice, Harvey Pass, Hisao Asamura, David Waller, John Edwards, Walter Weder, Hans Hoffmann, Jan P. Van Meerbeeck

Research output: Contribution to journalArticle

188 Citations (Scopus)

Abstract

BACKGROUND: The current staging system for malignant pleural mesothelioma (MPM) is controversial. To plan revisions of this system, the International Association for the Study of Lung Cancer Staging Committee developed an international database. Initial analyses focus on patients managed surgically. METHODS: Participation was solicited from centers known to have MPM registries. Common data elements were analyzed by the International Association for the Study of Lung Cancer Staging Committee Statistical Center. Survival was analyzed by the Kaplan-Meier method, prognostic factors by log rank and Cox regression model. p Value less than 0.05 was significant. RESULTS: Data included 3101 patients (15 centers, 4 continents). Demographics: median age 63 years, 79% men, 62.3% epithelioid tumor. Best tumor, node, metastasis (bTNM) stages were: I (11%), II, (21%), III (48%), and IV (20%). Curative-intent surgery was performed in 1494 patients (64.5%). Median survivals by clinical TNM and pathological TNM were similar: stage I, 21 months; stage II, 19 months; stage III, 16 months; and stage IV, 12 months. Median survival by histology: epithelioid 19 months, biphasic 13 months, and sarcomatoid 8 months. By multivariable analyses, significant differences in overall survival were seen for: T4 versus T3 and T3 versus T2 but not T2 versus T1; N0 versus N1 and N2 but not N1 versus N2; stages III and IV versus I but not II versus I; epithelioid histology versus other; age of female versus age of male; and palliative versus curative-intent surgery. CONCLUSIONS: This is the largest international database examining outcomes in surgically managed MPM patients. Survival differences reported from smaller databases are confirmed but suggest the need to revise tumor and node staging.

Original languageEnglish
Pages (from-to)1631-1639
Number of pages9
JournalJournal of Thoracic Oncology
Volume7
Issue number11
DOIs
Publication statusPublished - 2012 Nov
Externally publishedYes

Fingerprint

Mesothelioma
Lung Neoplasms
Databases
Survival
Histology
Neoplasm Staging
Proportional Hazards Models
Registries
Neoplasms
Demography
Neoplasm Metastasis
Malignant Mesothelioma

Keywords

  • Maligant pleural mesothelioma
  • Revision of staging system
  • Staging

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine

Cite this

Rusch, V. W., Giroux, D., Kennedy, C., Ruffini, E., Cangir, A. K., Rice, D., ... Van Meerbeeck, J. P. (2012). Initial analysis of the international association for the study of lung cancer mesothelioma database. Journal of Thoracic Oncology, 7(11), 1631-1639. https://doi.org/10.1097/JTO.0b013e31826915f1

Initial analysis of the international association for the study of lung cancer mesothelioma database. / Rusch, Valerie W.; Giroux, Dorothy; Kennedy, Catherine; Ruffini, Enrico; Cangir, Ayten K.; Rice, David; Pass, Harvey; Asamura, Hisao; Waller, David; Edwards, John; Weder, Walter; Hoffmann, Hans; Van Meerbeeck, Jan P.

In: Journal of Thoracic Oncology, Vol. 7, No. 11, 11.2012, p. 1631-1639.

Research output: Contribution to journalArticle

Rusch, VW, Giroux, D, Kennedy, C, Ruffini, E, Cangir, AK, Rice, D, Pass, H, Asamura, H, Waller, D, Edwards, J, Weder, W, Hoffmann, H & Van Meerbeeck, JP 2012, 'Initial analysis of the international association for the study of lung cancer mesothelioma database', Journal of Thoracic Oncology, vol. 7, no. 11, pp. 1631-1639. https://doi.org/10.1097/JTO.0b013e31826915f1
Rusch, Valerie W. ; Giroux, Dorothy ; Kennedy, Catherine ; Ruffini, Enrico ; Cangir, Ayten K. ; Rice, David ; Pass, Harvey ; Asamura, Hisao ; Waller, David ; Edwards, John ; Weder, Walter ; Hoffmann, Hans ; Van Meerbeeck, Jan P. / Initial analysis of the international association for the study of lung cancer mesothelioma database. In: Journal of Thoracic Oncology. 2012 ; Vol. 7, No. 11. pp. 1631-1639.
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abstract = "BACKGROUND: The current staging system for malignant pleural mesothelioma (MPM) is controversial. To plan revisions of this system, the International Association for the Study of Lung Cancer Staging Committee developed an international database. Initial analyses focus on patients managed surgically. METHODS: Participation was solicited from centers known to have MPM registries. Common data elements were analyzed by the International Association for the Study of Lung Cancer Staging Committee Statistical Center. Survival was analyzed by the Kaplan-Meier method, prognostic factors by log rank and Cox regression model. p Value less than 0.05 was significant. RESULTS: Data included 3101 patients (15 centers, 4 continents). Demographics: median age 63 years, 79{\%} men, 62.3{\%} epithelioid tumor. Best tumor, node, metastasis (bTNM) stages were: I (11{\%}), II, (21{\%}), III (48{\%}), and IV (20{\%}). Curative-intent surgery was performed in 1494 patients (64.5{\%}). Median survivals by clinical TNM and pathological TNM were similar: stage I, 21 months; stage II, 19 months; stage III, 16 months; and stage IV, 12 months. Median survival by histology: epithelioid 19 months, biphasic 13 months, and sarcomatoid 8 months. By multivariable analyses, significant differences in overall survival were seen for: T4 versus T3 and T3 versus T2 but not T2 versus T1; N0 versus N1 and N2 but not N1 versus N2; stages III and IV versus I but not II versus I; epithelioid histology versus other; age of female versus age of male; and palliative versus curative-intent surgery. CONCLUSIONS: This is the largest international database examining outcomes in surgically managed MPM patients. Survival differences reported from smaller databases are confirmed but suggest the need to revise tumor and node staging.",
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AU - Rice, David

AU - Pass, Harvey

AU - Asamura, Hisao

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