WCLC 2025 - Posters & ePosters-EP.14.04 Mapping the Pleural Mesothelioma: Incidence, Treatment Patterns and Outcomes From Endemic Pocket in Southern Rajasthan, India

EP.14.04 Mapping the Pleural Mesothelioma: Incidence, Treatment Patterns and Outcomes From Endemic Pocket in Southern Rajasthan, India

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This study from Geetanjali Medical College and Hospital, Udaipur, India, retrospectively analyzed 88 cases of malignant pleural mesothelioma (MPM) treated between May 2018 and December 2024, focusing on an emerging endemic hotspot in southern Rajasthan. MPM is a rare, aggressive cancer strongly linked to asbestos exposure, which remains prevalent in countries like India and China. Due to low awareness and poor data collection, MPM is likely underreported in India.<br /><br />Out of the total cases, 64 were concentrated within a 150 km radius across three major districts. Patients’ ages ranged from 26 to 88 years, with a male-to-female ratio of 1.8:1. Notably, 56% of patients initially received empirical antitubercular treatment (ATT), reflecting a common misdiagnosis due to overlapping symptoms with tuberculosis, which delayed appropriate cancer treatment. The median symptom duration was six months; dyspnea was most common (66%). Diagnosis was primarily made via thoracoscopy (63 patients), with CT-guided biopsies in others. Histologically, the epithelioid subtype dominated (62%), followed by sarcomatoid (17%) and biphasic (10%) types.<br /><br />Treatment included neoadjuvant chemo/immunotherapy in 73% of patients, yet only 23 underwent surgery—12 had extended pleurectomy, 7 underwent extrapleural pneumonectomy, and 4 had palliative partial pleurectomy due to advanced disease. After a median 22-month follow-up, 62% had died, 25% were disease-free, and 13% remained alive with disease.<br /><br />Concluding, MPM in this endemic zone remains a deadly disease with poor outcomes despite multimodal treatment. The overlap with tuberculosis leads to delayed diagnosis and treatment. The identification of this hotspot necessitates focused efforts to determine causal factors and improve preventive and therapeutic interventions.

Asset Subtitle

Ashish Jakhetiya

Meta Tag

Speaker Ashish Jakhetiya

Topic Mesothelioma, Thymoma, and Other Thoracic Tumors

Keywords

malignant pleural mesothelioma

MPM

Geetanjali Medical College

Udaipur

southern Rajasthan

asbestos exposure

misdiagnosis tuberculosis

thoracoscopy diagnosis

epithelioid subtype

multimodal treatment