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Treatment patterns among patients with malignant pleural mesothelioma: An Italian, population‐based nationwide study

BACKGROUND: Malignant pleural mesothelioma (MPM) is a rare cancer with a poor prognosis. Centralization of rare cancer in dedicated centers is recommended to ensure expertise, multidisciplinarity and access to innovation. In Italy, expert centers for MPM have not been identified in all regions. We a...

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Autores principales: Trama, Annalisa, Proto, Claudia, Signorelli, Diego, Garassino, Marina C., Lo Russo, Giuseppe, Ganzinelli, Monica, Prelaj, Arsela, Mensi, Carolina, Gangemi, Manuela, Gennaro, Valerio, Chellini, Elisabetta, Caldarella, Adele, Angelillo, Italo F., Ascoli, Valeria, Pascucci, Cristiana, Tagliabue, Giovanna, Cusimano, Rosanna, Bella, Francesca, Falcini, Fabio, Merler, Enzo, Masanotti, Giuseppe, Ziino, Antonio, Michiara, Maria, Gola, Gemma, Storchi, Cinzia, Mangone, Lucia, Vitale, Maria F., Cirilli, Claudia, Tumino, Rosario, Scuderi, Tiziana, Fanetti, Anna C., Piffer, Silvano, Tiseo, Marcello, Gatta, Gemma, Botta, Laura
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons Australia, Ltd 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7262944/
https://www.ncbi.nlm.nih.gov/pubmed/32364316
http://dx.doi.org/10.1111/1759-7714.13456
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author Trama, Annalisa
Proto, Claudia
Signorelli, Diego
Garassino, Marina C.
Lo Russo, Giuseppe
Ganzinelli, Monica
Prelaj, Arsela
Mensi, Carolina
Gangemi, Manuela
Gennaro, Valerio
Chellini, Elisabetta
Caldarella, Adele
Angelillo, Italo F.
Ascoli, Valeria
Pascucci, Cristiana
Tagliabue, Giovanna
Cusimano, Rosanna
Bella, Francesca
Falcini, Fabio
Merler, Enzo
Masanotti, Giuseppe
Ziino, Antonio
Michiara, Maria
Gola, Gemma
Storchi, Cinzia
Mangone, Lucia
Vitale, Maria F.
Cirilli, Claudia
Tumino, Rosario
Scuderi, Tiziana
Fanetti, Anna C.
Piffer, Silvano
Tiseo, Marcello
Gatta, Gemma
Botta, Laura
author_facet Trama, Annalisa
Proto, Claudia
Signorelli, Diego
Garassino, Marina C.
Lo Russo, Giuseppe
Ganzinelli, Monica
Prelaj, Arsela
Mensi, Carolina
Gangemi, Manuela
Gennaro, Valerio
Chellini, Elisabetta
Caldarella, Adele
Angelillo, Italo F.
Ascoli, Valeria
Pascucci, Cristiana
Tagliabue, Giovanna
Cusimano, Rosanna
Bella, Francesca
Falcini, Fabio
Merler, Enzo
Masanotti, Giuseppe
Ziino, Antonio
Michiara, Maria
Gola, Gemma
Storchi, Cinzia
Mangone, Lucia
Vitale, Maria F.
Cirilli, Claudia
Tumino, Rosario
Scuderi, Tiziana
Fanetti, Anna C.
Piffer, Silvano
Tiseo, Marcello
Gatta, Gemma
Botta, Laura
author_sort Trama, Annalisa
collection PubMed
description BACKGROUND: Malignant pleural mesothelioma (MPM) is a rare cancer with a poor prognosis. Centralization of rare cancer in dedicated centers is recommended to ensure expertise, multidisciplinarity and access to innovation. In Italy, expert centers for MPM have not been identified in all regions. We aimed to describe the treatment patterns among MPM patients across different Italian regions and to identify factors associated with the treatment patterns across the regions. METHODS: We performed an observational study on a random sample of 2026 MPM patients diagnosed in 2003–2008. We included 26 population‐based registries covering 70% of the Italian population. To identify factors associated with treatment patterns, across the different regions, we fitted a multinomial logistic regression model adjusted by age, sex, stage, histology and hospital with thoracic surgical department. RESULTS: MPM patients mostly received chemotherapy alone (41%) or no cancer‐directed therapy (36%) especially the older patients. The first course of treatment for MPM patients differed across regions. Patients from Piedmont, Liguria and Campania were more likely to receive no cancer‐directed therapy; those living in Tuscany and Sicily were more likely to get surgery; patients from Marche and Lazio were more likely to receive chemotherapy. These differences were not explained by age, sex, stage, histology and availability of a thoracic surgery department. CONCLUSIONS: There is limited expertise available and lack of a network able to maximize the expertise available may contribute to explaining the results of our study. Our findings support the need to ensure the appropriate care of all MPM patients in reorganizing the health care services. KEY POINTS: SIGNIFICANT FINDINGS OF THE STUDY: MPM patients mostly received chemotherapy alone or no cancer‐directed therapy especially the older patients. The first course of treatment for MPM patients differed across Italian regions. WHAT THIS STUDY ADDS: Differences in MPM clinical management are not explained by the age, stage, histology nor by the availability of a thoracic surgery department. Limited expertise for MPM contribute to explaining the unequal access to appropriate care for MPM patients in Italy.
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spelling pubmed-72629442020-06-03 Treatment patterns among patients with malignant pleural mesothelioma: An Italian, population‐based nationwide study Trama, Annalisa Proto, Claudia Signorelli, Diego Garassino, Marina C. Lo Russo, Giuseppe Ganzinelli, Monica Prelaj, Arsela Mensi, Carolina Gangemi, Manuela Gennaro, Valerio Chellini, Elisabetta Caldarella, Adele Angelillo, Italo F. Ascoli, Valeria Pascucci, Cristiana Tagliabue, Giovanna Cusimano, Rosanna Bella, Francesca Falcini, Fabio Merler, Enzo Masanotti, Giuseppe Ziino, Antonio Michiara, Maria Gola, Gemma Storchi, Cinzia Mangone, Lucia Vitale, Maria F. Cirilli, Claudia Tumino, Rosario Scuderi, Tiziana Fanetti, Anna C. Piffer, Silvano Tiseo, Marcello Gatta, Gemma Botta, Laura Thorac Cancer Original Articles BACKGROUND: Malignant pleural mesothelioma (MPM) is a rare cancer with a poor prognosis. Centralization of rare cancer in dedicated centers is recommended to ensure expertise, multidisciplinarity and access to innovation. In Italy, expert centers for MPM have not been identified in all regions. We aimed to describe the treatment patterns among MPM patients across different Italian regions and to identify factors associated with the treatment patterns across the regions. METHODS: We performed an observational study on a random sample of 2026 MPM patients diagnosed in 2003–2008. We included 26 population‐based registries covering 70% of the Italian population. To identify factors associated with treatment patterns, across the different regions, we fitted a multinomial logistic regression model adjusted by age, sex, stage, histology and hospital with thoracic surgical department. RESULTS: MPM patients mostly received chemotherapy alone (41%) or no cancer‐directed therapy (36%) especially the older patients. The first course of treatment for MPM patients differed across regions. Patients from Piedmont, Liguria and Campania were more likely to receive no cancer‐directed therapy; those living in Tuscany and Sicily were more likely to get surgery; patients from Marche and Lazio were more likely to receive chemotherapy. These differences were not explained by age, sex, stage, histology and availability of a thoracic surgery department. CONCLUSIONS: There is limited expertise available and lack of a network able to maximize the expertise available may contribute to explaining the results of our study. Our findings support the need to ensure the appropriate care of all MPM patients in reorganizing the health care services. KEY POINTS: SIGNIFICANT FINDINGS OF THE STUDY: MPM patients mostly received chemotherapy alone or no cancer‐directed therapy especially the older patients. The first course of treatment for MPM patients differed across Italian regions. WHAT THIS STUDY ADDS: Differences in MPM clinical management are not explained by the age, stage, histology nor by the availability of a thoracic surgery department. Limited expertise for MPM contribute to explaining the unequal access to appropriate care for MPM patients in Italy. John Wiley & Sons Australia, Ltd 2020-05-04 2020-06 /pmc/articles/PMC7262944/ /pubmed/32364316 http://dx.doi.org/10.1111/1759-7714.13456 Text en © 2020 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Trama, Annalisa
Proto, Claudia
Signorelli, Diego
Garassino, Marina C.
Lo Russo, Giuseppe
Ganzinelli, Monica
Prelaj, Arsela
Mensi, Carolina
Gangemi, Manuela
Gennaro, Valerio
Chellini, Elisabetta
Caldarella, Adele
Angelillo, Italo F.
Ascoli, Valeria
Pascucci, Cristiana
Tagliabue, Giovanna
Cusimano, Rosanna
Bella, Francesca
Falcini, Fabio
Merler, Enzo
Masanotti, Giuseppe
Ziino, Antonio
Michiara, Maria
Gola, Gemma
Storchi, Cinzia
Mangone, Lucia
Vitale, Maria F.
Cirilli, Claudia
Tumino, Rosario
Scuderi, Tiziana
Fanetti, Anna C.
Piffer, Silvano
Tiseo, Marcello
Gatta, Gemma
Botta, Laura
Treatment patterns among patients with malignant pleural mesothelioma: An Italian, population‐based nationwide study
title Treatment patterns among patients with malignant pleural mesothelioma: An Italian, population‐based nationwide study
title_full Treatment patterns among patients with malignant pleural mesothelioma: An Italian, population‐based nationwide study
title_fullStr Treatment patterns among patients with malignant pleural mesothelioma: An Italian, population‐based nationwide study
title_full_unstemmed Treatment patterns among patients with malignant pleural mesothelioma: An Italian, population‐based nationwide study
title_short Treatment patterns among patients with malignant pleural mesothelioma: An Italian, population‐based nationwide study
title_sort treatment patterns among patients with malignant pleural mesothelioma: an italian, population‐based nationwide study
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7262944/
https://www.ncbi.nlm.nih.gov/pubmed/32364316
http://dx.doi.org/10.1111/1759-7714.13456
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