Diffuse malignant pleural mesothelioma: A multi-institutional clinicopathological study
- 71 Downloads
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 wordsDiffuse malignant pleural mesothelioma Hyaluronic acid Thoracoscopic pleural biopsy Pleuropneumonectomy
Unable to display preview. Download preview PDF.
- 12.Boersma A, Degand P, Biserte G. Hyaluronic acid analysis and the diagnosis of pleural mesothelioma. Bull Eur Physiopath Resp 1980;16:41–45.Google Scholar
- 16.Rush VW, Piantadosi S, Holmes EC. The role of extrapleural pneumonectomy in malignant pleural mesothelioma. A Lung Cancer Study Group trial. J Thorac Cardiovasc Surg 1991;102:1–9.Google Scholar
- 17.Allen KB, Faber LP, Warren WH. Malignant pleural mesothelioma. Extrapleural pneumonectomy and pleurectomy. Chest Surg Clin North Am 1994;4:113–126.Google Scholar
- 18.Sugarbaker DJ, Flores RM, Jaklitsch MT, Richards WG, Strauss GM, Corson JM, et al. Resection margins, extrapleural nodal status, and cell type determine postoperative long-term survival in trimodality therapy of malignant pleural mesothelioma: results in 183 patients. J Thorac Cardiovasc Surg 1999;117:54–65.PubMedCrossRefGoogle Scholar
- 22.Yusa T, Yasukawa T, Kunitomo F, Yamamoto T, Ozaki D. A case of diffuse malignant pleural mesothelioma treated by intrathoracic perfusion chemohyperthermia after pleuropneumonectomy (in Japanese with English abstract). Jpn J Lung Cancer 2003;43:357–361.Google Scholar