Introduction

Optimal care in malignant pleural mesothelioma (MPM) requires specialist diagnostic tools, histology, and effusion management, providing a rationale for specialist multi-disciplinary team (sMDT) working. The Scottish Mesothelioma Network, established in April 2019, coordinates a national sMDT and provision of specialist services.

Aims

We hypothesize that sMDT care is associated with improved overall survival in MPM.

Methods

All Scottish cases diagnosed April 2017-January 2022 were allocated to pre- and post-network cohorts. Data was extracted from local and national databases. Overall survival was recorded from date of first suspicious imaging to death. All cases had ?12-months follow-up. Restricted Mean Survival Time (RMST) at 1 year was used for survival analyses. 

Results

654 patients were studied (pre n=282, post n=327). Unadjusted RMST analysis (Figure 1A) revealed superior mean survival in post-network cases at 1-year. This retained statistical significance on adjusted analysis (+0.6 months, p=0.013). Subgroup analysis showed marked survival improvement in post-network non-epithelioid cases (Figure 1B).

Conclusions

Establishment of a sMDT is associated with improved overall mean survival. This may be driven by improvements in non-epithelioid survival. Enhanced access to therapy, trials and holistic care may explain our findings; analyses are ongoing. These data support wider adoption of sMDTs.