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Socioeconomic status does not appear to affect overall survival (OS) in patients with operable malignant pleural mesothelioma (MPM), according to research presented at the IASLC 2021 World Conference on Lung Cancer (WCLC).
In a retrospective analysis, researchers evaluated factors associated with OS in 2804 patients with MPM.
The patients were diagnosed from 2004 to 2017 and had potentially operable stage I to IIIa disease. The patients’ median age at baseline was 65 years (range, 58-70 years), 29.5% were women, and 82.8% were White.
Half of patients underwent surgery, and the other half did not (1402 patients in each group). Among patients who underwent surgery, 30.2% were women, 83.1% were White, 86.7% had stage I or II disease, 47.7% had private insurance, and 44.6% had Medicare. More than half of surgeries (57.3%) took place in academic centers, high-volume facilities, and metropolitan areas.
In a multivariable analysis, there was no significant difference in OS by socioeconomic status, insurance status, education, comorbidity index, race, or facility type and volume.
Factors associated with poor OS were advanced age (adjusted hazard ratio [aHR], 1.02; 95% CI, 1.02-1.03) and male sex (aHR, 1.43; 95% CI, 1.29-1.58).
Factors associated with improved OS were:
- Receiving surgery and chemotherapy vs chemotherapy alone (aHR, 0.606; 95% CI, 0.549-0.668; P <.0001)
- Receiving surgery, radiotherapy, and chemotherapy vs chemotherapy alone (aHR, 0.728; 95% CI, 0.622-0.853; P <.0001).
- Prolonged chemotherapy (aHR, 0.998; 95% CI, 0.997-0.999; P =.0002).
Disclosures: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Rodriguez E. Socioeconomic disparities in access to treatment and survival in operable malignant pleural mesothelioma in the United States. Presented at: IASLC 2021 World Conference on Lung Cancer hosted by the International Association for the Study of Lung Cancer; September 8-14, 2021. Abstract OA13.02.