%0 Journal Article %A Elizabeth Hadley %A Terence O'Shaughnessy %A Fiona Breen %A Michael Apps %T Mesothelioma in north east London %D 2011 %J European Respiratory Journal %P p2823 %V 38 %N Suppl 55 %X The North East London Cancer Network (NELCN) has the second highest incidence of mesothelioma in the UK. The 2010 ERS/ESTS malignant pleural mesothelioma guidelines have subjected the evidence to systematic review and it was felt that the network should audit its own service in 2009 & 2010.There were 52 new cases of mesothelioma, data was obtained on 34. Of these patients 91% were pleural and 9% peritoneal. Over 90% was confirmed histologically. All patients were discussed in a multidiciplinary team meeting (MDT), 50% received chemotherapy. All patients who had a VATS biopsy had a surgical pleurodesis. At the end of the audit deadline 11/34 patients had died including all patients with sarcomatoid histology.Lung cancer patients in the NELCN are known to present late with advanced disease, only 41% of these patients came through a respiratory specialist as a first port of call, and only 35% as urgent cancer referrals.Chemotherapy was offered to 74% of patients, but only 50% had it. Most of those did not have chemotherapy because of poor performance status. However in two cases chemotherapy was delayed in order to wait for symptoms. The current ERS/ESTS evidence suggests that chemotherapy before symptom progression has a better outcome.Port site radiotherapy was given to a third of patients, those who did not have chemotherapy. This is in line with the BTS 2007 statement.The NELCN has a high case load of mesothelioma. Diagnostics are moving uniformly across the network towards early CT biopsy or VATs biopsy. Palliative surgical pleurodseis is common and chemotherapy is being offered to three quarters of patients. Mesothelioma MDTs are operational and assist in optimizing patient pathways. %U