TY - JOUR T1 - Predicting survival in malignant mesothelioma JF - European Respiratory Journal JO - Eur Respir J SP - 1420 LP - 1424 DO - 10.1183/09031936.00000811 VL - 38 IS - 6 AU - A.W. Musk AU - N. Olsen AU - H. Alfonso AU - A. Reid AU - R. Mina AU - P. Franklin AU - J. Sleith AU - N. Hammond AU - T. Threlfall AU - K.B. Shilkin AU - N.H. de Klerk Y1 - 2011/12/01 UR - http://erj.ersjournals.com/content/38/6/1420.abstract N2 - Malignant mesothelioma (MM) of the pleura or peritoneum is a universally fatal disease attracting an increasing range of medical interventions and escalating healthcare costs. Changes in survival and the factors affecting survival of all patients ever diagnosed with MM in Western Australia over the past five decades and confirmed by the Western Australian Mesothelioma Registry to December 2005 were examined. Sex, age, date and method of diagnosis, site of disease and histological type were recorded. Date of onset of symptoms and performance status were obtained from clinical notes for a sample of cases. Cox regression was used to examine the association of the clinical variables and the 10-yr periods of disease onset with survival after diagnosis. Survival was inversely related to age, being worse for males (hazard ratio (HR) 1.4, 95% CI 1.2–1.6), and those with peritoneal mesothelioma (HR 1.4, 95% CI 1.1–1.7). Patients with sarcomatoid histology had worse prognosis than patients with epithelioid and biphasic histological subtypes. Survival improved after the 1970s and has made incremental improvements since then. Median (interquartile range) survival by decade, from 1960 until 2005, was 64 (0–198), 177 (48–350), 221 (97–504), 238 (108–502) and 301 (134–611) days; ∼4 weeks of this apparent improvement can be attributed to earlier diagnosis. With increasing resources and treatment costs for MM over the past 40 yrs, there have been modest improvements in survival but no complete remissions. ER -