Abstract
Abstract only
e18501
Background: This is the first report on mesothelioma using Commission on Cancer National Cancer Database information and this is the largest study on mesothelioma to date. Methods: Using the National Cancer Database (NCDB) 26,605 patients diagnosed with mesothelioma between 2000 and 2010 were identified and analyzed. The NCDB contains data from more than 70% of all new cancers diagnosed in the U.S. each year. Results: The majority of mesothelioma patients are Caucasian (89%), males (78%), over the age of 70 (60%), and are diagnosed with stage IV disease (41%). The majority of patients (41%) received no first course treatment. The patients that were most likely to have surgery include patients <70 years old, at academic centers, with stage I-III disease, and of these only 37% received surgery and 15% received no first course treatment. The youngest patients <50 years received the most surgical therapy (36%) and the oldest patients >80 received the least (12%). Patients with private insurance received more surgical treatment (28%) than patients with Medicaid (22%), Medicare (18%), and VHA (12%)(p<0.009). Private insurance holders also received no first course treatment less often (29.6%) than Medicaid (37%), Medicare (46%), VHA (52%), and uninsured patients (37%)(p<0.002). Conclusions: The majority of patients with mesothelioma are elderly, Caucasian males and many of which do not receive treatment. The standard of care for resectable stage I-III mesothelioma includes surgery and chemotherapy. The results from this study indicate that 41% of all patients received no first course treatment and only 21% of patients received surgical treatment. Of patients most likely to receive surgery, only 37% of patients received surgical treatment and 15% of these patients did not receive any first course treatment. Age and insurance status also affect treatment as the youngest patients and private insurance holders received the most surgical treatment. [Table: see text]