bims-mesote 2026-02-08 papers

Issue of 2026–02–08
two papers selected by
Laura Mannarino, Humanitas Research

Front Public Health. 2025 ;13 1741506

Projecting future mortality risk of pleural mesothelioma in Italy (2020-2034): Bayesian age-period-cohort analysis over 40 years of death registration.

Allegra Sartore, Giorgia Stoppa, Giada Minelli, Carolina Mensi, Dario Consonni, Valerio Manno, Alessandro Marinaccio, Lucia Fazzo, Annibale Biggeri, Dolores Catelan.

Introduction: Italy, a major former producer, banned asbestos in 1992. A high incidence of mesothelioma, one of the asbestos legacies, is still observed due to the long latency and exposure from residual asbestos-containing materials. Future mortality forecasts at both national and subnational levels are still lacking. This work aims to project future age-stratified mortality rates (2020-2034) for pleural mesothelioma (PM) in Italy, both nationally and for each administrative region.
Methods: Data on pleural cancers and PM in Italy between 1980 and 2019 were extracted from death registries, adjusted for PM misclassification in ICD-9, and aggregated in eight periods, eighteen age classes, and fifteen birth cohorts. Bayesian age-period-cohort models were implemented to generate age-specific mortality projections, stratified by sex assigned at birth.
Results: Between 1980 and 2019, 33,889 people died from PM in Italy, and 19,092 more deaths are expected between 2020 and 2034. The national peak is predicted for 2020-2024, with 6,740 deaths. Age groups under 75 years have already reached the peak of mortality rates. Region-specific trends by sex and time reflect the country's industrialization history.
Discussion: These results align with the literature in predicting the timing of the mesothelioma peak and offer new insights into age-specific trends, the rate of decline, and geographical patterns. They provide valuable evidence on the heterogeneous asbestos legacy across regions, supporting targeted public health actions and health planning.

Keywords: Bayesian model; asbestos exposure; cancer epidemiology; epidemiological surveillance; forecasts; pleural mesothelioma

DOI: https://doi.org/10.3389/fpubh.2025.1741506

Ann Thorac Surg. 2026 Feb 02. pii: S0003-4975(26)00105-0. [Epub ahead of print]

Disaster on MARS2? Lessons Learned from Modern Day Outcomes of Surgery for Pleural Mesothelioma.

Shubham Gulati, Andrea Wolf, Jai Mehrotra-Varma, Stephanie Tuminello, Emanuela Taioli, Raja Flores.

BACKGROUND: The Mesothelioma and Radical Surgery 2 (MARS2) trial has drawn into question pleurectomy/decortication (PD) for the treatment of pleural mesothelioma. This trial's evaluation of resectability (poor PET-CT utilization, patients with non-epithelioid subtypes, etc.) and preference for extended PD (89% patients underwent this) may have led to the high in-hospital and 30-day mortality (both 4%) and 90-day mortality (9%). Many argue that surgical treatment for mesothelioma offers better outcomes in appropriately identified patients. The argument is based on case series prior to 2015 with limited discussion of surgical details. We present our institutional outcomes in carefully-characterized pleural mesothelioma during the time MARS2 was completed, highlighting management and outcomes in the same period.
METHODS: Our database was screened for patients from 2015-2021 treated with PD for pleural mesothelioma. Patients undergoing extrapleural pneumonectomy were excluded. Electronic medical records were queried for dates of surgery, last follow-up, and death; preoperative tests; operative details; and postoperative outcomes. Electronically available obituaries were reviewed to supplement survival data. Descriptive variables and post-surgical survival were analyzed.
RESULTS: Seventy-one patients underwent PD for pleural mesothelioma. Histological diagnosis demonstrated 56 (78.9%) epithelioid, 13 (18.3%) biphasic, and 2 (2.8%) sarcomatoid PM. All 71 (100%) had pulmonary function tests and PET-CT. In-hospital and 30-day mortality were 0 and 90-day mortality was 3/71 (4.2%).
CONCLUSIONS: PD can be done safely, with low post-operative mortality. With strict selection criteria and resection focused on balancing cytoreduction with patients' tolerance for aggressive surgery, short-term complications and mortality of PD in pleural mesothelioma can be limited.

DOI: https://doi.org/10.1016/j.athoracsur.2026.01.025