Clinical Research Papers:
Distinctive clinical characteristics of malignant mesothelioma in young patients
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Anish Thomas1,*, Yuanbin Chen1,*, Tinghui Yu2, Ammara Gill3 and Vinay Prasad4
1 Thoracic and GI Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
2 Office of Surveillance and Biometrics, Center for Devices and Radiological Health, FDA, Silver Spring, MD, USA
3 Meyer Orthopedic and Rehabilitation Hospital, Springfield, MO, USA
4 Medical Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
* These authors have contributed equally to this work
Vinay Prasad, email:
Keywords: mesothelioma, SEER analysis, incidence among the young, asbestos
Received: May 20, 2015 Accepted: May 27, 2015 Published: June 10, 2015
Although considered a disease of the elderly, a subset of patients with mesothelioma are young (<40 years). The goal of this study was to understand their characteristics and outcomes. The Surveillance, Epidemiology, and End Results (SEER) database was used to extract mesothelioma cases (1990-2010). We modeled Kaplan-Meyer survival curves stratified by site of disease, and age of presentation. 2% (207 of 12345) of mesothelioma patients are young. Sex distribution is comparable among the young (51% males, 49% females); males predominated (78%, 22%) in the older cohort. Frequency of pleural and peritoneal mesothelioma are similar in the young (47%, 48% respectively); pleural disease predominated in the old (90%, 9%). Cancer-directed surgeries are more frequent in the young. Regardless of histologic subtype, young patients with pleural (11 vs. 8 months) and peritoneal (not reached vs. 10 months) mesothelioma had significantly improved overall survival. In multivariate analysis, younger age was an independent prognostic factor. Although rare, mesothelioma do occur in the young; their characteristics are distinct from those of older patients. Further studies are needed to understand the interplay between genetic susceptibility and mineral fiber carcinogenesis in the pathogenesis of mesothelioma in the young.
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