Asbestos Diseases Research Institute, Sydney, New South Wales, Australia.
Intern Med J. 2013 Apr;43(4):402-10. doi: 10.1111/j.1445-5994.2012.02925.x.
The silent epidemic of mesothelioma in Australia is steadily increasing, and 30% of cases occur in New South Wales (NSW).
To describe the patterns of care and outcomes of patients with malignant pleural mesothelioma (MPM) in NSW.
MPM patients in NSW applying for compensation at the NSW Dust Diseases Board from 2007 to 2009 were included. Survival from time of diagnosis was determined by the Kaplan-Meier method. The Chi-squared test was used to determine if there was an association between utilisation of treatment and geographical location.
A total of 138 patients was included: median age was 72.5; 91.3% male; 60.1% epithelial subtype; and 65.2% lived in major cities. All patients had at least one chest X-ray and computed tomography scan, and 21% had a positron emission tomography scan; 93.5% and 4.3% had histological or cytological confirmation respectively. Thoracoscopy (59.4%) was the most commonly used diagnostic procedure. Treatment utilisation: 53.6% chemotherapy; 35.5% radiotherapy; 9.4% extrapleural pneumonectomy (EPP); and 72.5% had palliative care involvement. There were no major differences in treatment utilisation between patients living in major cities and those in regional NSW (chemotherapy P = 0.42; radiotherapy P = 0.13 and palliative care P = 0.60), except for a higher rate of EPP in regional patients (16.7% vs 5.6%; P = 0.03). Median survival was 9.7 versus 12.3 months for city and regional patients respectively (P = 0.22).
Survival and treatment utilisation was not significantly different between MPM patients living in major cities and regional NSW, except for a higher rate of EPP in patients in regional NSW.
澳大利亚间皮瘤的无声流行正在稳步加剧，30%的病例发生在新南威尔士州（NSW）。
描述新南威尔士州恶性胸膜间皮瘤（MPM）患者的治疗模式和结局。
纳入 2007 年至 2009 年在新南威尔士州粉尘疾病委员会申请赔偿的新南威尔士州 MPM 患者。通过 Kaplan-Meier 法确定从诊断时起的生存情况。采用卡方检验确定治疗利用与地理位置之间是否存在关联。
共纳入 138 例患者：中位年龄为 72.5 岁；91.3%为男性；上皮亚型占 60.1%；65.2%居住在主要城市。所有患者均至少进行了一次胸部 X 线和计算机断层扫描检查，21%进行了正电子发射断层扫描；93.5%和 4.3%分别有组织学或细胞学证实。胸腔镜检查（59.4%）是最常用的诊断程序。治疗利用情况：53.6%接受化疗；35.5%接受放疗；9.4%行胸膜外全肺切除术（EPP）；72.5%接受姑息治疗。居住在主要城市和新南威尔士州农村地区的患者在治疗利用方面没有明显差异（化疗 P=0.42；放疗 P=0.13，姑息治疗 P=0.60），但农村地区患者 EPP 率较高（16.7%比 5.6%；P=0.03）。城市和农村地区患者的中位生存时间分别为 9.7 个月和 12.3 个月（P=0.22）。
除了农村地区患者 EPP 率较高外，居住在主要城市和新南威尔士州农村地区的 MPM 患者的生存和治疗利用没有显著差异。
