Mesothelioma is a disease with a poor prognosis. Treatment options are limited and usually palliative. There is little recent published data on how patients are treated in routine practice in Victoria, Australia. The aim of this study was to perform a review of patterns of care for pleural mesothelioma in regional Victoria.
The Evaluation of Cancer Outcomes (ECO) Registry records clinical and treatment information on all newly diagnosed cancer patients in the Barwon South West Region (BSWR) of Victoria encompassing approximately 380,000 people. This study analysed patterns of care and outcomes for all pleural mesothelioma patients diagnosed in the BSWR from 2009-2015.
There were 84 patients diagnosed with pleural mesothelioma during the 6 year period, with a median age of 72 (range 43-98). Forty-seven (56%) were current or ex-smokers and 28 (33%) were never smokers. Twelve (14%) patients had incomplete data with some component of treatment received outside the region. Thirty (36%) were recorded in the medical record as having asbestos exposure. A total of 45 (54%) patients received chemotherapy, usually pemetrexed with cisplatin or carboplatin. Only three (3.6%) patients received any subsequent surgical treatment and 15 (18%) patients received palliative radiotherapy. Thirty-three (39%) patients were recorded as receiving no active treatment for their mesothelioma after diagnosis. The median survival for all patients was 10.4 months with patients receiving chemotherapy having an overall survival of 14.2 months and patients not receiving further treatment a median survival of 4.7 months.
This population based analysis has confirmed the continuing poor outlook of this patient group. Patients receiving no further treatment after diagnosis and patients receiving chemotherapy had median survivals of 4.7 and 14.2 months respectively. These relatively large differences are likely explained by both patient and treatment factors. Pleural mesothelioma remains an area of unmet clinical need.