Fatma M A Abouelkasem
Cairo University, Egypt
Title: Malignant Pleual Mesothelioma (MPM) among decades in Egypt
Biography
Biography: Fatma M A Abouelkasem
Abstract
Introduction: MPM is extremely aggressive and has a long-latency period. Hence, detected at advanced stages resulting in an unfavorable prognosis(1-2years). However, MPM prognosis has been improving over the past few years with availability of better diagnostic and treatment regimens.
Purpose:
We aim to compare clinic-pathologic characteristics of old-MPM cases referred to National Cancer Institute (NCI)-Cairo university between( 2000-2003)and new MPM cases(2012-2015). Pearson's Chi(X2)and Fisher's Exact t-tests were used for statistical analysis.
Results:
1) Old cohort (n=100):100 patients were encountered. Median age was 46 years. Males were 59% of cases. 30% has ECOG-PS1. Asbestos exposure in 74cases. 44cases were smokers, 25cases were industrial-workers. Family history was positive in 12cases. Dyspnea in 92cases, chest pain in 83% and effusion in all cases, pleural thickening in 80%, tracheal shift to the opposite-side in 23%, Epithelioid subtype represented 46.6%. Pathological T2 represented 34%. 2) New cohort (n=194):194 patients were encountered. Median age was 53 years (range; 15-76). Males and females were nearly equally distributed. Pathological subtypes were epithelioid, biphasic and sarcomatoid in 63.4, 24.7 and 11.8% respectively. Right-sided lesions were evident in nearly two-thirds of the cases. Pleural thickening was nodular in 131(69.7%) cases. Inter-lobar fissure was thickened in 29.4%. Mediastinal Pleura was affected in 37.1%. Nearly, half of our cases had effusion. Ossification & calcification were detected in 8(4.1%) cases.
CONCLUSIONS:
By comparing both groups, we found that more lymph node involvement(N+), less metastasis(M+),older median age, more females, more epithelial subtype, less pleural effusion presentation, more pleural thickening and OS (p< 0.001) were detected in group 2(new cases) reflecting better staging ( mediastinoscopy & PET-CT),early detection, more incidence in females and better treatment modalities.