الفهرس 
ETIOLOGY AND RISK FACTORSOnly 14 pages are availabe for public view
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Abstract
M
alignant pleural mesothelioma is a rare tumor of pleural membrane of lungs and comprise a wide array of varying biological aggressiveness. Data regarding the epidemiology of mesotheliomas is presented in the literature and vary according to many factors and hence consequently affect the outcome.
We aimed at retrospectively analysing clinico- epidemiological characteristics and survival outcomes of adult malignant pleural mesothelioma patients presented to clinical oncology department in Ain Shams University hospital (ASU) in Cairo, Egypt in the period from 2017 till 2020.
Convenient sampling of 120 patients with adult malignant pleural mesothelioma was done. The primary objective was to analyze the epidemiological and demographic data and to assess progression free survival (PFS) after each treatment modality in the study population. Secondary objectives included overall survival its correlation with various factors as well as treatment toxicities.
One hundred twenty participants were included, with a median age of 56.5 years, with a male to female ratio of 1:1.14. Incidence was more common among Shubra Al Khaima and Helwan residents accounting for 35.8% and 15% of the cases respectively. Epithelioid mesothelioma was the most common pathological subtype representing 86.6% of the cases. Most of the cases were stage I at presentation.
The most common presenting symptom was dyspnea, while the second most common was chest pain. Only 6.7% of cases were eligible for surgical intervention during course of treatment, while 77.5% received 1st line chemotherapy and only 26.7% received second line. Palliative radiotherapy was used in 15.8% of the cases to relieve chest pain or symptoms of mediastinal syndrome.
The median overall survival was estimated to be 8 months for all patients. Patients with better ECOG status of 1-2 as well as patients at earlier stage of the disease showed improved OS compared to other patients with poor performance status at presentation and advanced stages.
CONCLUSION
M
esothelioma in Egypt is mainly concentrated in areas of high environmental pollution. We aimed to provide retrospective data of epidemiological, clinic-pathological and outcomes of adult MPM patients. Better environmental control programme would benefit Egypt.
LIMITATIONS
O
ur study had many limitations, the most prominent being the retrospective nature of collection of data through hospital records. This has the potential for incomplete data collection due to missing data in the records. Also, lack of standardization of laboratory and imaging investigations due to variability of laboratory and personal evaluation. Moreover, in our study the role of novel targeted and immunotherapies could not be evaluated among the patients due to lack of genetic testing and unavailability of these drugs in our study setting.
RECOMMENDATIONS
E
fforts should be directed to optimizing the multidisciplinary team that includes cardiothoracic surgeons, oncologists, radiotherapists, and nurses in order to achieve optimum treatment outcomes as resection of the tumor and further management. Efforts should also be directed towards improving outcomes of the disease and give maximum support to patients and their caregivers.