{
  "abstract": "Introduction Equitable delivery of high-quality care is challenging in mesothelioma. Previous UK audits report variable practice and outcomes. The Scottish Mesothelioma Network was launched in April 2019, funding lead clinicians and clinical nurse specialists, a weekly national multidisciplinary team meeting and service improvement driven by quality performance indicators. We report outcomes from an embedded impact assessment.Research design and methods A multicentre ambispective cohort study was performed, including all cases diagnosed from April 2017 to April 2022. Baseline data, treatment and survival outcomes were collected prospectively in all network cases (April 2019 to April 2022) and West of Scotland (WoS) pre-network cases (April 2017 to March 2019). Data were retrieved retrospectively for pre-network non-WoS cases via cancer networks, supplemented by Public Health Scotland registry data. Overall survival (OS) was compared between pre-network and network cohorts using restricted mean survival time (RMST). RMST differences were integrated with baseline features and treatment utilisation, including ipilimumab-nivolumab and surgery. Treatment effects were modelled by propensity score matching.Results 659 consecutive patients were included (pre-network n=273; network n=386). Cohort demographics were well-balanced. In the network era, data quality improved and diagnostic pathways were not delayed. Adjusted RMST was 4.13 months longer in non-epithelioid network cases (p<0.001), but did not differ in epithelioid cases. Ipilimumab-nivolumab was used more commonly in network cases (47/279 (16.8%) vs 4/154 (2.6%) performance status (PS) 0–1 pre-network), but similar RMST extension was observed in untreated patients (+4.45 months, p=0.01). RMST differences were associated with improved PS at diagnosis, but not with stage, ipilimumab-nivolumab or surgery (in 17/659 (2.6%)).Conclusion Establishment of a national mesothelioma network was associated with improved OS in non-epithelioid patients. Causal inferences cannot be drawn using the methods used, but these data support wider development of specialist mesothelioma networks.",
  "authors": [
    {
      "affiliations": [
        "Glasgow Pleural Disease Unit, Queen Elizabeth University Hospital, Glasgow, UK",
        "School of Cancer Sciences, University of Glasgow, Glasgow, UK"
      ],
      "name": "Matthew Tate"
    },
    {
      "affiliations": [
        "School of Cancer Sciences, University of Glasgow, Glasgow, UK"
      ],
      "name": "Joshua Joseph Roche"
    },
    {
      "affiliations": [
        "Glasgow Pleural Disease Unit, Queen Elizabeth University Hospital, Glasgow, UK",
        "School of Cancer Sciences, University of Glasgow, Glasgow, UK"
      ],
      "name": "Selina Tsim"
    },
    {
      "affiliations": [
        "Glasgow Pleural Disease Unit, Queen Elizabeth University Hospital, Glasgow, UK"
      ],
      "name": "Neil McGlinchey"
    },
    {
      "affiliations": [
        "Glasgow Pleural Disease Unit, Queen Elizabeth University Hospital, Glasgow, UK"
      ],
      "name": "Katie Ferguson"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Western General Hospital, Edinburgh, UK"
      ],
      "name": "Phil Reid"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Ninewells Hospital and Medical School, Dundee, UK"
      ],
      "name": "Philip Short"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Aberdeen Royal Infirmary, Aberdeen, UK"
      ],
      "name": "Mahendran Chetty"
    },
    {
      "affiliations": [
        "Beatson West of Scotland Cancer Centre, Glasgow, UK"
      ],
      "name": "Clinton Ali"
    },
    {
      "affiliations": [
        "Beatson West of Scotland Cancer Centre, Glasgow, UK"
      ],
      "name": "Noelle O’Rourke"
    },
    {
      "affiliations": [
        "Department of Oncology, Raigmore Hospital, Inverness, UK"
      ],
      "name": "Carol MacGregor"
    },
    {
      "affiliations": [
        "Glasgow Pleural Disease Unit, Queen Elizabeth University Hospital, Glasgow, UK"
      ],
      "name": "Carolyn MacRae"
    },
    {
      "affiliations": [
        "Glasgow Pleural Disease Unit, Queen Elizabeth University Hospital, Glasgow, UK"
      ],
      "name": "Laura McNaughton"
    },
    {
      "affiliations": [
        "Glasgow Pleural Disease Unit, Queen Elizabeth University Hospital, Glasgow, UK"
      ],
      "name": "Rebecca Bloomfield"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Aberdeen Royal Infirmary, Aberdeen, UK"
      ],
      "name": "Tracey Petrie"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Ninewells Hospital and Medical School, Dundee, UK"
      ],
      "name": "Susan Smyth"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Raigmore Hospital, Inverness, UK"
      ],
      "name": "Jennifer Latham"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, St John’s Hospital at Howden, Livingston, UK"
      ],
      "name": "Lynne Hunter"
    },
    {
      "affiliations": [
        "Golden Jubilee National Hospital West of Scotland Regional Heart and Lung Centre, Glasgow, UK"
      ],
      "name": "Rocco Bilancia"
    },
    {
      "affiliations": [
        "Golden Jubilee National Hospital West of Scotland Regional Heart and Lung Centre, Glasgow, UK"
      ],
      "name": "Alan Kirk"
    },
    {
      "affiliations": [
        "Department of Pathology, Queen Elizabeth University Hospital, Glasgow, UK"
      ],
      "name": "Craig Dick"
    },
    {
      "affiliations": [
        "Department of Pathology, Queen Elizabeth University Hospital, Glasgow, UK"
      ],
      "name": "Fiona Roberts"
    },
    {
      "affiliations": [
        "Department of Pathology, Queen Elizabeth University Hospital, Glasgow, UK"
      ],
      "name": "Elaine MacDuff"
    },
    {
      "affiliations": [
        "Department of Pathology, Queen Elizabeth University Hospital, Glasgow, UK"
      ],
      "name": "Jill Slavin"
    },
    {
      "affiliations": [
        "Department of Pathology, Queen Elizabeth University Hospital, Glasgow, UK"
      ],
      "name": "Hemamalini Pitchamuthu"
    },
    {
      "affiliations": [
        "Department of Radiology, Queen Elizabeth University Hospital, Glasgow, UK"
      ],
      "name": "Gordon W Cowell"
    },
    {
      "affiliations": [
        "Department of Radiology, Queen Elizabeth University Hospital, Glasgow, UK"
      ],
      "name": "Simon Sheridan"
    },
    {
      "affiliations": [
        "Department of Radiology, Queen Elizabeth University Hospital, Glasgow, UK"
      ],
      "name": "Mike Gronski"
    },
    {
      "affiliations": [
        "Department of Radiology, Queen Elizabeth University Hospital, Glasgow, UK"
      ],
      "name": "Liam Peng"
    },
    {
      "affiliations": [
        "Department of Radiology, Glasgow Royal Infirmary, Glasgow, UK"
      ],
      "name": "Laura Thomson"
    },
    {
      "affiliations": [
        "Department of Radiology, Glasgow Royal Infirmary, Glasgow, UK"
      ],
      "name": "Colin Noble"
    },
    {
      "affiliations": [
        "Department of Radiology, University Hospital Crosshouse, Kilmarnock, UK"
      ],
      "name": "John Maguire"
    },
    {
      "affiliations": [
        "The Prince and Princess of Wales Hospice, Glasgow, UK"
      ],
      "name": "Laura Kelly"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Raigmore Hospital, Inverness, UK"
      ],
      "name": "Elizabeth Sage"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Aberdeen Royal Infirmary, Aberdeen, UK"
      ],
      "name": "Fiona Thomson"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Aberdeen Royal Infirmary, Aberdeen, UK"
      ],
      "name": "Ratna Alluri"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Victoria Hospital, Kirkaldy, UK"
      ],
      "name": "Joe MacKenzie"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Ninewells Hospital and Medical School, Dundee, UK"
      ],
      "name": "Helen Liddicoat"
    },
    {
      "affiliations": [
        "Mesothelioma UK, Leicester, UK"
      ],
      "name": "Liz Darlison"
    },
    {
      "affiliations": [
        "Glasgow Pleural Disease Unit, Queen Elizabeth University Hospital, Glasgow, UK"
      ],
      "name": "Elaine Smith"
    },
    {
      "affiliations": [
        "Scottish Cancer Network, NHS National Services Scotland, Glasgow, UK"
      ],
      "name": "Anna Morton"
    },
    {
      "affiliations": [
        "Glasgow Pleural Disease Unit, Queen Elizabeth University Hospital, Glasgow, UK",
        "School of Cancer Sciences, University of Glasgow, Glasgow, UK",
        "Cancer Research UK Scotland Institute, Glasgow, UK"
      ],
      "name": "Kevin G Blyth"
    }
  ],
  "title": "Impact of a national mesothelioma network on outcomes including survival",
  "uid": "96943daa-48ea-5618-9a6e-38c3f20bf9f6"
}