Clinical and prognostic factors in pleural mesothelioma: insights from a Latin American cohort

Our plain-English summary of Clinical and prognostic factors in pleural mesothelioma: insights from a Latin American cohort, by R. Brugés, C. Carvajal, M. Núñez, et al (Clinical & Translational Oncology, 2026).

The study

• Authors: R. Brugés, C. Carvajal, M. Núñez, A. Navarrete, R. Parra-Medina
• Journal: Clinical & Translational Oncology
• Published: 2026;28(10):4839-4848
• Read it: PubMed · Publisher · Free full text

Abstract

Background: Pleural mesothelioma (PM) remains a lethal but preventable disease whose burden is shifting toward low- and middle-income countries (LMICs) where asbestos use has persisted or has only recently been banned. This study describes the clinical characteristics, management patterns, and prognostic factors of PM in a contemporary Colombian cohort.

Methods: We conducted a retrospective cohort study of adults with histologically confirmed pleural mesothelioma diagnosed at a tertiary referral cancer center in Bogotá, Colombia, from January 1, 2011, to December 31, 2023. Overall survival (OS) was defined from the histologic diagnosis date to death from any cause; patients without a recorded death were censored at the last documented oncologic contact. Real-world progression-free survival (PFS) was defined from diagnosis to documented progression (radiologic or clinician-documented) or death, whichever occurred first; patients without progression or death were censored at last contact. Survival was estimated using Kaplan-Meier methods and modeled using Cox proportional hazards regression.

Results: The cohort included 106 patients (mean age, 63.2 years; 73.6% male; 84.9% epithelioid histology). There were 105 deaths (1 OS censor). Median OS was 9.9 months (95% CI, 7.1-14.1), with 12- and 24 month OS of 46.2% and 12.3%. Real-world PFS included 105 events (1 PFS censor). Median PFS was 8.1 months (95% CI, 6.2-9.4), with 12- and 24 month PFS of 30.2% and 6.6%. In multivariable analyses focused on baseline prognostic factors, ECOG performance status 2-3 was associated with shorter OS and PFS.

Conclusions: In this contemporary Colombian cohort, OS and PFS were short, and baseline functional status was strongly associated with outcomes. Treatment-stratified survival patterns are reported descriptively and should not be interpreted as comparative effectiveness. These data add regional evidence for pleural mesothelioma prognosis in routine practice.

© 2026. The Author(s).

In plain English

This retrospective study reviewed records of 106 adults with pleural mesothelioma seen from 2011 to 2023 at Colombia's Instituto Nacional de Cancerología. Mean age was 63.2 years; 73.6% were men; 84.9% had epithelioid tumors. Records showed asbestos exposure alone in 15.1% and with tobacco in 27.4%. The authors said this likely underestimated true exposure. All but one patient died. Median overall survival was 9.9 months (95% CI 7.1 to 14.1); 46.2% (37.6 to 56.8) survived 12 months and 12.3% (7.4 to 20.4) 24 months. Median survival was 4.8 months with poorer functional status (ECOG performance status 2 to 3) versus 13.7 months with ECOG 0 to 1. The adjusted hazard ratio for death, ECOG 2 to 3 versus 0 to 1, was 3.33 (95% CI 1.94 to 5.73). Sarcomatoid tumors were associated with shorter overall and progression-free survival; platelets of 400 x 10^9/L or more, with shorter overall but not progression-free survival. The authors read tumor-type estimates cautiously, given small groups. The authors concluded survival was short and baseline functional status strongly associated with outcomes. They noted possible selection bias and modest sample size.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Retrospective, single-center cohort study based on existing clinical records and archived tissue
• Who was studied: 106 adults (18 or older) with histologically confirmed pleural mesothelioma seen in thoracic surgery or medical oncology at the Instituto Nacional de Cancerología, Bogotá, Colombia, between January 1, 2011 and December 31, 2023. Mean age 63.2 years, 73.6% male (78 patients), 84.9% epithelioid histology (90 patients), 7.5% biphasic (8) and 7.5% sarcomatoid (8). Follow-up data cutoff was August 10, 2024.
• Exposure: Not an exposure study. Exposure history was taken from medical records: asbestos alone in 16 patients (15.1%), tobacco alone in 28 (26.4%), asbestos and tobacco in 29 (27.4%), and none in 33 (31.1%). Asbestos fiber types, jobs and doses were not reported. The study mainly examined clinical and laboratory prognostic factors (age, sex, ECOG performance status, stage, histologic subtype, platelet count) and treatments received.
• Main results:
  • Whole cohort: 105 of 106 patients died during follow-up. Median overall survival was 9.9 months (95% CI 7.1 to 14.1). Overall survival was 46.2% at 12 months (95% CI 37.6 to 56.8) and 12.3% at 24 months (95% CI 7.4 to 20.4).
  • Whole cohort: median real-world progression-free survival was 8.1 months (95% CI 6.2 to 9.4). Progression-free survival was 30.2% at 12 months and 6.6% at 24 months. 56 patients (52.8%) had documented progression.
  • In unadjusted analysis, patients with ECOG performance status 0 to 1 had a median overall survival of 13.7 months, compared with 4.8 months for patients with ECOG 2 to 3 (log-rank p less than 0.001).
  • In multivariable models, ECOG 2 to 3 compared with ECOG 0 to 1 had an adjusted hazard ratio of 3.33 (95% CI 1.94 to 5.73) for overall survival and 3.12 (95% CI 1.81 to 5.39) for progression-free survival.
  • In multivariable models, sarcomatoid compared with epithelioid histology had an adjusted hazard ratio of 4.19 (95% CI 1.85 to 9.49) for overall survival and 4.09 (95% CI 1.78 to 9.41) for progression-free survival. Biphasic compared with epithelioid was not statistically significant (OS hazard ratio 1.03, 95% CI 0.48 to 2.21). The authors interpreted histology estimates cautiously because the non-epithelioid groups were small.
  • Platelet count of 400 x 10^9/L or more, compared with below 400, had an adjusted hazard ratio of 1.71 (95% CI 1.09 to 2.69, p 0.020) for overall survival. For progression-free survival the hazard ratio was 1.26 (95% CI 0.81 to 1.96, p 0.297), which was not statistically significant.
  • Treatments recorded in the text: palliative chemotherapy in 59 patients (55.6%), extrapleural pneumonectomy in 10 (9.4%), and best supportive care in 21 (19.8%). Median time from diagnosis to treatment start was 3.53 months. Survival curves by treatment were presented only descriptively, not as a comparison of effectiveness.
• The authors' conclusion: The authors concluded that overall survival and real-world progression-free survival were short in this Colombian cohort, and that baseline ECOG performance status was strongly associated with outcomes. They stated that treatment-stratified survival curves are descriptive and should not be read as comparative effectiveness.
• Limitations the authors state:
  • Retrospective design and reliance on institutional records may have introduced selection bias.
  • Data on radiotherapy dosing and quality of life were limited.
  • The sample size was modest compared with international registries.
  • Recorded asbestos exposure likely underestimates true asbestos contact because of incomplete occupational histories, informal employment and recall limitations.
  • The surgical subgroup was small, so similar survival curves for surgery and palliative chemotherapy should not be read as equivalence.
  • Models that included treatment were exploratory because of confounding by indication.
  • There was some evidence of nonproportional hazards for age and clinical stage, so adjusted hazard ratios are average effects over follow-up.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Cohort Study, Overall Survival, Progression-Free Survival, Epithelioid, Histology, ECOG Performance Status, Prognosis.

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