Treatment patterns among patients with malignant pleural mesothelioma: An Italian, population‐based nationwide study
Abstract 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 regio...
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Wiley
2020-06-01
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Series: | Thoracic Cancer |
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Online Access: | https://doi.org/10.1111/1759-7714.13456 |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Annalisa Trama Claudia Proto Diego Signorelli Marina C. Garassino Giuseppe Lo Russo Monica Ganzinelli Arsela Prelaj Carolina Mensi Manuela Gangemi Valerio Gennaro Elisabetta Chellini Adele Caldarella Italo F. Angelillo Valeria Ascoli Cristiana Pascucci Giovanna Tagliabue Rosanna Cusimano Francesca Bella Fabio Falcini Enzo Merler Giuseppe Masanotti Antonio Ziino Maria Michiara Gemma Gola Cinzia Storchi Lucia Mangone Maria F. Vitale Claudia Cirilli Rosario Tumino Tiziana Scuderi Anna C. Fanetti Silvano Piffer Marcello Tiseo Gemma Gatta Laura Botta the LUME study WG |
spellingShingle |
Annalisa Trama Claudia Proto Diego Signorelli Marina C. Garassino Giuseppe Lo Russo Monica Ganzinelli Arsela Prelaj Carolina Mensi Manuela Gangemi Valerio Gennaro Elisabetta Chellini Adele Caldarella Italo F. Angelillo Valeria Ascoli Cristiana Pascucci Giovanna Tagliabue Rosanna Cusimano Francesca Bella Fabio Falcini Enzo Merler Giuseppe Masanotti Antonio Ziino Maria Michiara Gemma Gola Cinzia Storchi Lucia Mangone Maria F. Vitale Claudia Cirilli Rosario Tumino Tiziana Scuderi Anna C. Fanetti Silvano Piffer Marcello Tiseo Gemma Gatta Laura Botta the LUME study WG Treatment patterns among patients with malignant pleural mesothelioma: An Italian, population‐based nationwide study Thoracic Cancer Logistic models mesothelioma malignant registries therapeutics |
author_facet |
Annalisa Trama Claudia Proto Diego Signorelli Marina C. Garassino Giuseppe Lo Russo Monica Ganzinelli Arsela Prelaj Carolina Mensi Manuela Gangemi Valerio Gennaro Elisabetta Chellini Adele Caldarella Italo F. Angelillo Valeria Ascoli Cristiana Pascucci Giovanna Tagliabue Rosanna Cusimano Francesca Bella Fabio Falcini Enzo Merler Giuseppe Masanotti Antonio Ziino Maria Michiara Gemma Gola Cinzia Storchi Lucia Mangone Maria F. Vitale Claudia Cirilli Rosario Tumino Tiziana Scuderi Anna C. Fanetti Silvano Piffer Marcello Tiseo Gemma Gatta Laura Botta the LUME study WG |
author_sort |
Annalisa Trama |
title |
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_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_sort |
treatment patterns among patients with malignant pleural mesothelioma: an italian, population‐based nationwide study |
publisher |
Wiley |
series |
Thoracic Cancer |
issn |
1759-7706 1759-7714 |
publishDate |
2020-06-01 |
description |
Abstract 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. |
topic |
Logistic models mesothelioma malignant registries therapeutics |
url |
https://doi.org/10.1111/1759-7714.13456 |
work_keys_str_mv |
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doaj-02f86e80f4c448e49c3063f2482869272020-11-25T03:05:23ZengWileyThoracic Cancer1759-77061759-77142020-06-011161661166910.1111/1759-7714.13456Treatment patterns among patients with malignant pleural mesothelioma: An Italian, population‐based nationwide studyAnnalisa Trama0Claudia Proto1Diego Signorelli2Marina C. Garassino3Giuseppe Lo Russo4Monica Ganzinelli5Arsela Prelaj6Carolina Mensi7Manuela Gangemi8Valerio Gennaro9Elisabetta Chellini10Adele Caldarella11Italo F. Angelillo12Valeria Ascoli13Cristiana Pascucci14Giovanna Tagliabue15Rosanna Cusimano16Francesca Bella17Fabio Falcini18Enzo Merler19Giuseppe Masanotti20Antonio Ziino21Maria Michiara22Gemma Gola23Cinzia Storchi24Lucia Mangone25Maria F. Vitale26Claudia Cirilli27Rosario Tumino28Tiziana Scuderi29Anna C. Fanetti30Silvano Piffer31Marcello Tiseo32Gemma Gatta33Laura Botta34the LUME study WG35Research Department Fondazione IRCCS Istituto Nazionale dei Tumori Milan ItalyDepartment of Medical Oncology Fondazione IRCCS, Istituto Nazionale dei Tumori Milan ItalyDepartment of Medical Oncology Fondazione IRCCS, Istituto Nazionale dei Tumori Milan ItalyDepartment of Medical Oncology Fondazione IRCCS, Istituto Nazionale dei Tumori Milan ItalyDepartment of Medical Oncology Fondazione IRCCS, Istituto Nazionale dei Tumori Milan ItalyDepartment of Medical Oncology Fondazione IRCCS, Istituto Nazionale dei Tumori Milan ItalyDepartment of Medical Oncology Fondazione IRCCS, Istituto Nazionale dei Tumori Milan ItalyCOR Lombardy, Epidemiology Unit,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and University of Milan Milan ItalyUnit of Cancer Epidemiology University of Turin and CPO‐Piemonte Turin ItalyCOR Liguria, UO Epidemiology IRCCS Ospedale Policlinico San Martino Genoa ItalyUnit of Occupational & Environmental Epidemiology, Tuscan Occupational Cancer Registry Institute for Cancer Research, Prevention and Clinical Network (ISPRO) Florence ItalyTuscan Cancer Registry, Institute for Cancer Research Prevention and Clinical Network (ISPRO) Florence ItalyDepartment of Experimental Medicine, COR Campania University of Campania "Luigi Vanvitelli" Naples ItalyDepartment of Radiological Sciences, Oncology and Anatomical Pathology, COR Lazio University La Sapienza Rome ItalyMesothelioma Marche Registry ‐ COR Marche, School of Medicinal and Health Products Sciences University of Camerino Camerino ItalyVarese Cancer Registry Fondazione IRCCS Istituto Nazionale dei Tumori Milan ItalyPalermo Cancer Registry Palermo ItalyIntegrated Cancer Registry of Catania‐Messina‐Siracusa‐Enna Azienda Ospedaliero‐Universitaria Policlinico‐Vittorio Emanuale Catania ItalyRomagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS Forlì ItalyCOR Veneto, Occupational Health Unit, Department of Prevention Padua ItalySec. Public Health, Department of Experimental Medicine, COR Umbria University of Perugia Perugia ItalySiracusa Cancer Registry Siracusa ItalyParma Cancer Registry Parma ItalyComo Cancer Registry Como ItalyServizio di Epidemiologia Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia Reggio Emilia ItalyServizio di Epidemiologia Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia Reggio Emilia ItalyU.O.S.D. Napoli 3 South Cancer Registry Piazza San Giovanni Naples ItalyModena Cancer Registry Modena ItalyCancer Registry and Histopathology Deaprtment, COR Sicily, 'Civic ‐M.P. Arezzo' Hospital Ragusa ItalyTrapani Cancer Registry Trapani ItalySondrio Cancer Registry Sondrio ItalyTrento Cancer Registry, Servizio Epidemiologia Clinica e Valutativa, Azienda Provinciale per i Servizi Sanitari Trento ItalyDepartment of Medicine and Surgery University of Parma Parma ItalyResearch Department Fondazione IRCCS Istituto Nazionale dei Tumori Milan ItalyResearch Department Fondazione IRCCS Istituto Nazionale dei Tumori Milan ItalyResearch Department Fondazione IRCCS Istituto Nazionale dei Tumori Milan ItalyAbstract 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.https://doi.org/10.1111/1759-7714.13456Logistic modelsmesothelioma malignantregistriestherapeutics |