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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

Abstract

Purpose

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.

Methods

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

Results

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.

Conclusions

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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References

  1. 1.
    Robinson BW, Musk AW, Lake RA. Malignant mesothelioma. Lancet 2005;366:397–40.PubMedCrossRefGoogle Scholar
  2. 2.
    Kanazawa N, Ioka A, Tsukuma H, Ajiki W, Oshima A. Incidence and survival of mesothelioma in Osaka, Japan. Jpn J Clin Oncol 2006;36:254–257.PubMedCrossRefGoogle Scholar
  3. 3.
    van Ruth S, Baas P, Zoetmulder FAN. Surgical treatment of malignant pleural mesothelioma. A review. Chest 2003;123:551–561.PubMedCrossRefGoogle Scholar
  4. 4.
    Ismail-Khan R, Robinson LA, Williams CC, Garett CR, Bepler G, Simon GR. Malignant pleural mesothelioma: a comprehensive review. Cancer Control 2006;13:255–263.PubMedGoogle Scholar
  5. 5.
    Morinaga K, Kishimoto T, Sakatani M, Akira M, Yokoyama K, Sera Y. Asbestos-related lung cancer and mesothelioma in Japan. Ind Health 2001;39:65–74.PubMedCrossRefGoogle Scholar
  6. 6.
    International Mesothelioma Interest Group. A proposed new international TNM staging system for malignant pleural mesothelioma. Chest 1995;108:1122–1128.CrossRefGoogle Scholar
  7. 7.
    Brenner J, Sordillo PP, Magill GB, Golbey RB. Malignant mesothelioma of the pleura: review of 123 patients. Cancer 1982;49:2431–2435.PubMedCrossRefGoogle Scholar
  8. 8.
    Adams VI, Unni KK, Muhm JR, Jett JR, Ilstrup DM, Bernatz PE. Diffuse malignant mesothelioma of pleura. Diagnosis and survival in 92 cases. Cancer 1986;58:1540–1551.PubMedCrossRefGoogle Scholar
  9. 9.
    Achatzy R, Beba W, Ritschler R, Wörn H, Wahlers B, Macha HN, et al. The diagnosis, therapy and prognosis of diffuse malignant mesothelioma. Eur J Cardiothorac Surg 1989;3:445–448.PubMedCrossRefGoogle Scholar
  10. 10.
    Ruffie P, Feld R, Minkin S, Cormier Y, Boutan-Laroze A, Ginsberg R, et al. Diffuse malignant mesothelioma of the pleura in Ontario and Quebec: a retrospective study of 332 patients. J Clin Oncol 1989;7:1157–1168.PubMedGoogle Scholar
  11. 11.
    Nesti M, Marinaccio A, Chellini E. Malignant mesothelioma in Italy, 1997. Am J Ind Med 2004;45:55–62.PubMedCrossRefGoogle Scholar
  12. 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
  13. 13.
    Boutin C, Rey F. Thoracoscopy in pleural malignant mesothelioma: a prospective study of 188 consecutive patients. Cancer 1993;72:389–393.PubMedCrossRefGoogle Scholar
  14. 14.
    Butchart EG, Ashcroft A, Barnsley C, Holden MP. Pleuropneumonectomy in the management of diffuse malignant mesothelioma of the pleura: experience with 29 patients. Thorax 1976;31:15–24.PubMedGoogle Scholar
  15. 15.
    DaValle MJ, Faber LP, Kittle CF, Jensik RJ. Extrapleural pneumonectomy for diffuse malignant mesothelioma. Ann Thorac Surg 1986;42:612–618.PubMedCrossRefGoogle Scholar
  16. 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. 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. 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
  19. 19.
    Takagi K, Tsuchiya R, Watanabe Y. Surgical approach to pleural diffuse mesothelioma in Japan. Lung Cancer 2001;31:57–65.PubMedCrossRefGoogle Scholar
  20. 20.
    Ho L, Sugarbaker DJ, Skarin AT. Malignant mesothelioma. Cancer Treat Res 2001;105:327–373.PubMedGoogle Scholar
  21. 21.
    Tagawa T, Yoshino I, Yamaguchi M, Osoegawa A, Kameyama T, Fukuyama S, et al. Intrapleural hypotonic cisplatin treatment for malignant pleural mesothelioma: in vitro experiments and clinical application. Surg Today 2006;36:135–139.PubMedCrossRefGoogle Scholar
  22. 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
  23. 23.
    Marinaccio A, Nesti M, Regional Operational Centers. Analysis of survival of mesothelioma cases in the Italian register (ReNaM). Eur J Cancer 2003;39:1290–1295.PubMedCrossRefGoogle Scholar
  24. 24.
    Yusa T, Iyoda A, Kadoyama C, Sasaki K, Suzuki M, Yamakawa H, et al. Diffuse malignant mesothelioma of the pleura. A clinical study of 51 cases from a multi-institutional study group (in Japanese with English abstract). Jpn J Lung Cancer 2005;45:241–247.CrossRefGoogle Scholar

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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