Introduction Mesothelioma is an uncommon malignancy with a poor prognosis, and in order to improve its management all cases within each cancer network should be discussed at a specialist MDT, which advises individual cancer units on the best treatment approach for their patients. We have reviewed the work of the specialist mesothelioma MDT for the Mersey and Cheshire Network (MCCN) since its inception in 2009.
Aim and Methods We assessed all patients referred from the 6 contributing lung cancer units (A to F) over 4 years, looking at histology, performance status (PS), investigations undertaken, treatments offered, and mortality rate.
Results Of 182 patients (mean age 76 years [SD 8], median PS 1, 157 male), 11 (6%) had a clinical diagnosis only. One hundred and seventy one patients had a tissue diagnosis (45% epitheliod, 7% sarcomatoid, 13% mixed, 29% unspecified). This was obtained by VATS in 79/171 (46%) and CT-guided biopsy in 43/171 (25%). 21 (12%) had a cytological diagnosis only.
MDT advice on treatment options was offered in all cases; 88 (48%) received radiotherapy and 51 (28%) chemotherapy. 142 (78%) patients have died (median survival of 378 days). 1-year and 2-year survival rates were 51.3% and 16.9% respectively. However, in those who received chemotherapy, survival improved significantly (1-year 91.7% and 2-year 63.5% respectively; both p < 0.0001).
Data for individual cancer units is given in the table (table 1).
Conclusions We have shown that those patients offered active treatment have a distinct survival advantage compared to the remainder. The cooperation of 6 cancer units in the MCCN to form a specialist mesothelioma network with a regular MDT has shown that this approach can improve the outcome for this unfortunate group of patients.