Impact of Age on Long-Term Outcomes of Surgery for Malignant Pleural Mesothelioma.

Journal Article (Journal Article)

BACKGROUND: Although malignant pleural mesothelioma (MPM) is generally a disease associated with more advanced age, the association of age, treatment, and outcomes has not been well-characterized. We evaluated the impact of age on outcomes in patients with MPM to provide data for use in the treatment selection process for elderly patients with potentially resectable disease. PATIENTS AND METHODS: Overall survival (OS) of patients younger than 70 and 70 years or older with Stage I to III MPM who underwent cancer-directed surgery or nonoperative management in the Surveillance, Epidemiology, and End Results database (2004-2010) was evaluated using multivariable Cox proportional hazard models and propensity score-matched analysis. RESULTS: Cancer-directed surgery was used in 284 of 879 (32%) patients who met inclusion criteria, and was associated with improved OS in multivariable analysis (hazard ratio, 0.71; P = .001). Cancer-directed surgery was used much less commonly in patients 70 years and older compared with patients younger than 70 years (22% [109/497] vs. 46% [175/382]; P < .001), but patients 70 years and older had improved 1-year (59.4% vs. 37.9%) and 3-year (15.4% vs. 8.0%) OS compared with nonoperative management. The benefit of surgery in patients 70 years and older was observed even after propensity score-matched analysis was used to control for selection bias. CONCLUSION: Surgical treatment is associated with improved survival compared with nonoperative management for both patients younger than 70 years and patients aged 70 years or older.

Full Text

Duke Authors

Cited Authors

  • Yang, C-FJ; Yan, BW; Meyerhoff, RR; Saud, SM; Gulack, BC; Speicher, PJ; Hartwig, MG; D'Amico, TA; Harpole, DH; Berry, MF

Published Date

  • September 2016

Published In

Volume / Issue

  • 17 / 5

Start / End Page

  • 419 - 426

PubMed ID

  • 27236386

Pubmed Central ID

  • PMC5026893

Electronic International Standard Serial Number (EISSN)

  • 1938-0690

Digital Object Identifier (DOI)

  • 10.1016/j.cllc.2016.03.002


  • eng

Conference Location

  • United States