The clinicopathological characteristics with long-term outcomes in malignant mesothelioma.

Malignant mesothelioma (MM) is a neoplasm which originates from serous membranes. It is relatively more common in Turkey. Ninety-nine patients between 2002-2009 were evaluated for survival and patient characteristics with chest pain, dyspnea, weight loss, loss of appetite, anemia, leukocytosis, thrombocytosis and lactate dehydrogenase (LDH) elevation, retrospectively. Male/female ratio was 1.41(58/41). Median age was 53(27-88). Asbestosis exposure rate was 78.5%. Most of the patients had better ECOG-PS (88.7% for 1-2). Chest pain (47.7%), dyspnea (44.8%), weight loss (49%), loss of appetite (50%), anemia (38%), leukocytosis (37.2%), thrombocytosis (26.6%) and LDH elevation (10.1%) were found with median values such as 11.8 g/dL (5-17.1) for hemoglobin, 8,800/mm3 for WBC (2,600-38,300), 382,000/mm(3) for platelets (28,000-1,504,000) and 253 IU/L for LDH (85-1,877), respectively. The most common site was pleura (62.3%). Half of the patients were unclassified, while epitheloid histopathology (39.4%) was most common in classified ones. RT rate was 42.1% in operated patients and all had pleural MM. Median OS was 22.9 months. Eighty percent of the patients had first-line CT with a clinical benefit rate of 63.3%. Second-line CT rate was 29% with a clinical benefit rate of 44%. Most preferred CT regimen was cisplatinum and pemetrexed. Most of the patients were male in their 50 s with pleural MM. They had chest pain, dyspnea, weight loss and loss of appetite as the most common symptoms at diagnosis. Only half of the patients could be subtyped with a predominance of epitheloid histology.