The presence of ‘non-expandable’ lung in patients with mesothelioma may be more common than previously reported and is linked to shorter survival, according to UK researchers who carried out a ten-year study.
In an analysis of 229 patients, a team from the Academic Respiratory Unit at the University of Bristol, found that more than eight in ten patients (n=192) presenting at their clinic with malignant pleural mesothelioma had pleural effusion.
And of these, a third (n=64) had non-expandable lung, defined by the researchers as the failure of lung re-expansion for any reason after fluid removal.
Further analysis of the data collected between 2008 and 2019 showed that the presence of non-expandable lung was an independent risk factor for short survival even when tumour stage was taken into account (HR for mortality 1.80; 95% CI 1.16 to 2.80).
Patients with pleural effusions, both with and without underlying non-expandable lung, were more likely to have epithelioid disease, early-stage disease and to receive chemotherapy than those without the excess fluid, the researchers reported in the Annals of the American Thoracic Society.
Study leader Dr Anna Bibby, a consultant respiratory physician and research fellow said very little was known about the relatively recently recognised condition.
While some researchers had reported rates of non-expandable lung in trial populations, this was the first observational study to describe both the prevalence and clinical implications in a routine setting, she told the limbic.