Surgery Today

, Volume 38, Issue 11, pp 993–998 | Cite as

Diffuse malignant pleural mesothelioma: A multi-institutional clinicopathological study

  • Akira Iyoda
  • Toshikazu Yusa
  • Chikabumi Kadoyama
  • Kazuyoshi Sasaki
  • Hideki Kimura
  • Hisami Yamakawa
  • Mitsutoshi Shiba
  • Takehiko Fujisawa
  • Ichiro Yoshino
Original Article



The relative rarity of malignant pleural mesothelioma (MPM) in Japan makes it difficult to perform a large-scale clinicopathological study of this tumor at a single institute. Thus, we performed a multiinstitutional study to evaluate the current status of diagnosis and treatment in Japan.


We analyzed the records of 65 patients with MPM, obtained from the 13 institutions comprising the Japanese Chiba Multicenter Study Group.


In 56 patients, the tumor was detected after a visit to a medical facility for subjective symptoms such as chest pain, shortness of breath, and cough. It took a median period of 2 months from the initial visit to establish the diagnosis. The overall survival rates of 33 patients with unresectable MPM 1, 2, and 3 years after the diagnosis were 40.5%, 10.8%, and 0%, respectively, whereas those of 32 patients who underwent surgery were 67.9%, 35.0% and 10.9%, respectively (P = 0.0035). According to multivariate analysis, histological type, International Mesothelioma Interest Group clinical stage, sex, and the presenting symptom of shortness of breath were significant prognostic factors.


The definitive diagnosis of early MPM is difficult, but establishing the best diagnostic modality would improve survival rates, since radical surgery is likely to be effective for resectable disease.

Key words

Diffuse malignant pleural mesothelioma Hyaluronic acid Thoracoscopic pleural biopsy Pleuropneumonectomy 


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Copyright information

© Springer 2008

Authors and Affiliations

  • Akira Iyoda
    • 1
  • Toshikazu Yusa
    • 2
  • Chikabumi Kadoyama
    • 3
  • Kazuyoshi Sasaki
    • 4
  • Hideki Kimura
    • 5
  • Hisami Yamakawa
    • 6
  • Mitsutoshi Shiba
    • 7
  • Takehiko Fujisawa
    • 1
  • Ichiro Yoshino
    • 1
  1. 1.Department of Thoracic Surgery, Graduate School of MedicineChiba UniversityChibaJapan
  2. 2.Department of General Thoracic SurgeryChiba Rosai HospitalChibaJapan
  3. 3.Department of General Thoracic SurgerySaitama Red Cross HospitalSaitamaJapan
  4. 4.Department of Thoracic SurgeryHamamatsu Medical CenterHamamatsuJapan
  5. 5.Division of General Thoracic SurgeryChiba Prefecture Cancer CenterChibaJapan
  6. 6.Department of General Thoracic SurgeryChiba-East National HospitalChibaJapan
  7. 7.Department of Thoracic SurgeryKimitsu-chuo HospitalChibaJapan

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