MIK665 (S-64315) Due to the appointment of a pathologists
Due to the appointment of a pathologists’ panel at national level to perform a pathological review, we could rule out that diagnosis misclassification occurred selectively in women and is responsible for the difference in survival between genders. Several studies have reported the role of gender in prognosis [17,20], which may reflect a biological difference. Recent molecular studies have provided new insights, in particular regarding the loss-of-function mutations in CDKN2A (p16), NF2 and BAP1 previously reported in pleural malignant mesothelioma [, , ]. The prognostic impact of these alterations was investigated in peritoneal mesothelioma [, , ]; it was found that the presence of a BAP1 mutation is a long-term survival factor, while the presence of homozygous CDKN2A MIK665 (S-64315) or hemizygous NF2 loss results in poor survival. Singhi et al. , in a series of 86 patients with peritoneal mesothelioma who benefited from cytoreductive surgery and hyperthermic intraperitoneal chemotherapy between 2001 and 2014, showed that peritoneal cancer index, extent of invasion, and combination of CDKN2A deletion and NF2 loss were prognostic factors independent of age. Gender and completeness of cytoreduction were not significant. However, there were no significant differences in the frequency of CDKN2A deletions, NF2 loss, and BAP1 expression between the 60 men and 26 women included in this study.
The diagnosis period also seems to play an important role in the prognosis. Continuous advances in the knowledge of mesothelioma, and therefore in medical imaging, immunohistochemical and molecular biology techniques allow for more efficient and earlier detection of this disease. With the introduction of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy, studies from the literature have reported significant improvement in survival for patients treated for a peritoneal mesothelioma [8,27,28]. In France, this heavy treatment has been performed on selected peritoneal mesothelioma patients since the early 1990s. Moreover, the French National Cancer Institute (INCa) supports the establishment of the RENAPE Network of expert and specialized centers in the management of this rare peritoneal disease in 2009. We may hypothesize that this policy leading to early diagnosis and better therapeutic management may explain the better prognosis in the most recent population (from 2010 to 2012). The RENAPE database [28,29] reported a median survival of 61 months and a 5-year OS of 53% on a series of 126 eligible cases with a median age of 56–59 years diagnosed between 1991 and 2014. According to the multivariate analysis performed, the only independent prognostic factors were the completeness of cytoreduction and the administration of neoadjuvant chemotherapy . This study did not take into account molecular markers.
Conflict of interest
Acknowledgements The authors wish to thank Dr Lynnette Fernandez-Cuesta for the English language correction and critical suggestions, Professor Jean Yves Blay and Thierry Durand ‘Cancer Center Leon Berard’ for their support and ‘Santé Publique France’ and ‘Institut National du Cancer’ for financial support to registries and Reference National Centers.
Introduction The Centers for Disease Control and Prevention (CDC) reports almost 23,000 people died of hepatocellular carcinoma (HCC) in the U.S. in 2012 and approximately 50% of all HCC incidence in the U.S. is caused by chronic Hepatitis C virus (HCV) infection . Identification and treatment of chronic HCV infection can reduce cancer risk by 75% ; yet, 50–75% of those with HCV are unaware they are infected . Recent data show individuals born between 1945 and 1965 (baby boomers) have nearly five times the HCV infection prevalence compared to other birth cohorts , and make up the majority of HCV-related morbidity and mortality . Therefore, in 2012, the CDC augmented their risk-based recommendations to also include a one-time HCV screening for all baby boomers . Despite these recommendations, nationally representative analyses by our team of the National Health Interview Survey (NHIS) demonstrated HCV screening among baby boomers was less than 13% in 2015 and had increased by less than 1% per year between 2013 and 2015 . These small increases were not likely to make a substantial impact in identification and treatment of HCV infection at the population-level. As a follow-up to the 2013–2015 analysis, our team used the newly released 2016 data to examine whether there were any changes in screening since the original analysis . Specifically we: 1) report serial, cross-sectional HCV screening prevalence for four birth cohorts of the NHIS sample from 2016; and 2) evaluate factors associated with ever having been screened for HCV by birth cohort. Similar to other studies using national datasets to examine health trends over time [8,9], this study adds an additional year of data to examine if current HCV screening is increasing over time. If screening is not increasing, this study provides important data to support future interventions, which groups are most in need of such interventions, and a current benchmark by which to judge future success.