Comparison of outcomes following a cytological or histological diagnosis of malignant mesothelioma

Sanjeevan Muruganandan, Helman Alfonso, Peter Franklin, Keith Shilkin, Amanda Segal, Nola Olsen, Alison Reid, Nick De Klerk, A. W. Musk, Fraser Brims

Research output: Contribution to journalArticlepeer-review

20 Citations (Scopus)


Background:Survival with the epithelioid subtype of malignant mesothelioma (MM) is longer than the biphasic or sarcomatoid subtypes. There is concern that cytology-diagnosed epithelioid MM may underdiagnose the biphasic subtype. This study examines survival differences between patients with epithelioid MM diagnosed by cytology only and other subtypes diagnosed by histology.Methods:Demographics, diagnosis method, MM subtype and survival were extracted from the Western Australia (WA) Mesothelioma Registry, which records details of all MM cases occurring in WA.Results:A total of 2024 MM cases were identified over 42 years. One thousand seven hundred forty-four (86.2%) were male, median (IQR) age was 68.6 (60.4-77.0) years. A total of 1212 (59.9%) cases were identified as epithelioid subtype of which 499 (41.2%) were diagnosed using fluid cytology only. Those with a cytology-only diagnosis were older than the histology group (median 70.2 vs 67.6 years, P<0.001), but median survival was similar (cytology 10.6 (5.5-19.2) vs histology 11.1 (4.8-19.8) months, P=0.727) and Cox regression modelling adjusting for age, sex, site and time since first exposure showed no difference in survival between the different diagnostic approaches.Conclusions:Survival of cytologically and histologically diagnosed epithelioid MM cases does not differ. A diagnostic tap should be considered adequate to diagnose epithelioid MM without need for further invasive testing.

Original languageEnglish
Pages (from-to)703-708
Number of pages6
JournalBritish Journal of Cancer
Issue number6
Publication statusPublished - 14 Mar 2017


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