A SEER stat analysis of epidemiological and anatomical prognostic indicators of mesothelioma.

Abstract

e20091 Background: Mesothelioma is a rare malignancy with a historically poor prognosis. The development is mostly related to asbestos exposure. However recent studies indicate genetic predisposition also plays a major role in their development. Understanding prognosticators can help predict outcomes and can guide personalized treatment planning based on patient characteristics. Methods: The data was collected from Surveillance, Epidemiology, and End Result database research plus data, 17 registries, November 2023 Sub (2000-2021). In total, 8556 cases of mesothelioma in adults aged 18 years or above were extracted using the ICD code 9050/3. We then stratified the data based on age, sex, race, primary site, laterality, and vital status. The analysis was further completed by comparing survival using the log-rank (Mantel-Cox) test (GraphPad Prism). Results: Of the 8557 patients analyzed, 74.92% were males. The incidence rates by race were white 79.1%, black 5.4%, Hispanic 11.6%, Asian/Pacific Islanders (PIs) 3.24%, and American Indians (AIs)/Alaskan Natives (ANs) 0.46%. The median age at diagnosis was 75 years, and the median overall survival (MoS) was 7 months. MoS for men was 6 months and 9 months for women (p<0.0001). MoS by age group was 26 months for 18–50 years, 9 months for 51–75 years, and 5 months for >76 years (p<0.0001). MoS by race was 7 months for whites and Asian/PIs, 6 months for blacks, 9 months for Hispanics, and 8 months for AIs/ANs (p<0.0001). MoS by primary site was 5 months for respiratory/thoracic organs, 3 months for abdominal/retroperitoneal structures, 1 month for the GI tract, and 25 months for reproductive organs (p<0.0001). The survival was statistically insignificant based on laterality. Conclusions: The significantly higher incidence in the white population suggests potential genetic factors that warrant further investigation. Median survival declines with age. Better outcomes in patients with reproductive organ primaries may result from localized presentation enabling more effective surgical resections, with possible contributions from histological and hormonal factors as well. Similarly, improved outcomes in females may involve hormonal influences, as prior evidence suggests female sex hormones positively affect peritoneal mesothelioma outcomes. Combining these anatomical and prognostic indicators with clinical and radiological factors could enhance outcome prediction.