Background/Objectives: Time to treatment initiation (TTI) has been identified as a predictor of survival in many cancers, but its impact on malignant pleural mesothelioma (MPM) is unknown. This study investigates factors influencing TTI in MPM and its association with overall survival. Methods: The Surveillance, Epidemiology, and End Results (SEER) database was used to obtain data for MPM patients in the United States. TTI was defined as the number of days from diagnosis to initiation of first treatment, and delayed TTI was defined as exceeding the median TTI. Χ2tests andt-tests compared sociodemographic and clinical differences between early and delayed TTI groups, while Kaplan–Meier and Cox proportional hazards models evaluated relationships between prognostic factors, TTI, and survival. Results: Among 4879 MPM patients, the median TTI was 39 days. Median survival was 10 months among early TTI patients and 13 months among delayed TTI patients. Patients with epithelioid histology were more likely to have delayed TTI, as were patients who received combination therapy or were diagnosed more recently (p< 0.0001). Adjusting for covariates, delayed TTI status remained associated with better survival (HR 0.79, 95% CI: 0.74–0.84). Conclusions: This study presents an important insight into the management of MPM, demonstrating that delayed time to treatment initiation is positively associated with improved overall survival, contrary to findings in most cancers. This finding underscores the importance of comprehensive, multidisciplinary care, as delays due to robust staging evaluations and patient travel to high-volume centers of excellence likely contribute to delays in treatment. Taken together, these results suggest that clinicians should prioritize personalized treatment planning and collaborative care over a push to rapidly initiate treatment to optimize patient outcomes in MPM.
背景/目的：治疗启动时间（TTI）已被证实是多种癌症生存率的预测因子，但其对恶性胸膜间皮瘤（MPM）的影响尚不明确。本研究探讨影响MPM患者TTI的因素及其与总生存期的关联。方法：利用美国监测、流行病学和最终结果（SEER）数据库获取MPM患者数据。TTI定义为从确诊到首次接受治疗的天数，延迟TTI定义为超过中位TTI。采用χ²检验和t检验比较早期与延迟TTI组的社会人口学和临床特征差异，同时使用Kaplan-Meier法和Cox比例风险模型评估预后因素、TTI与生存期之间的关系。结果：在4879例MPM患者中，中位TTI为39天。早期TTI患者的中位生存期为10个月，延迟TTI患者为13个月。上皮样组织学类型患者、接受联合治疗患者以及近期确诊患者更可能出现延迟TTI（p<0.0001）。校正协变量后，延迟TTI状态仍与更好的生存期相关（HR 0.79，95% CI：0.74–0.84）。结论：本研究为MPM的临床管理提供了重要见解，表明与大多数癌症的研究结果相反，延迟治疗启动时间与改善总生存期呈正相关。这一发现强调了全面多学科诊疗的重要性，因为详尽的分期评估和患者转诊至高水平诊疗中心可能导致治疗延迟。综合来看，这些结果表明临床医生应优先考虑个体化治疗规划和协作诊疗模式，而非盲目追求快速启动治疗，以优化MPM患者的临床结局。
肿瘤(癌症)患者之家