Online citations, reference lists, and bibliographies.
← Back to Search

Malignant Pleural Mesothelioma: Clinicopathologic And Survival Characteristics In A Consecutive Series Of 394 Patients.

P. Borasio, A. Berruti, A. Billè, P. Lausi, M. G. Levra, R. Giardino, F. Ardissone
Published 2008 · Medicine

Cite This
Download PDF
Analyze on Scholarcy
OBJECTIVE Treatment of malignant pleural mesothelioma (MPM) remains disappointing, although recent reports suggest that multimodality therapy including surgery may provide a significant survival benefit. The aims of this single institution study were: to investigate clinicopathologic characteristics and potential prognostic factors in MPM patients, and to ascertain whether surgery followed by adjuvant therapy had an independent prognostic role. METHODS Retrospective review of a prospectively compiled computerized database of all patients with MPM evaluated between 1989 and 2003. Kaplan-Meier method, log-rank test, and Cox model were used in the statistical analysis. RESULTS There were 394 patients: 270 men (68.5%), 124 women, median age 64 (range 28-93). Twenty-seven patients (6.8%) underwent surgical resection (extrapleural pneumonectomy 15, pleurectomy/decortication 12), followed by adjuvant therapy. As of March 2006, 381 patients (96.7%) had died (median survival, 11.7 months; range 0.03-117.9). Median follow-up of 13 surviving patients (3.3%) was 45.2 months (range 28.7-126.5). Overall survival at 2 years was 18.8%. Multimodality therapy including surgery yielded a median survival of 14.5 months and a 2-year survival rate of 29.6%. Using univariate analysis, age (p=0.009), chest pain (p=0.01), weight loss (p=0.001), performance status (p=0.0001), platelet count (p=0.008), histology (p=0.0001), macroscopic appearance of pleural surface (non-specific inflammation, tumor-like thickening, or nodules; p=0.0001), visceral pleura involvement (p=0.0001), degree of involvement of pleural cavity (less than or more than one third of the cavity; p=0.0001), and multimodality therapy (p<0.01) were found to be significant prognostic factors. At multivariate analysis, performance status, platelet count, histology, and degree of involvement of pleural cavity remained independently associated with survival, whereas multimodality therapy failed to enter the model. CONCLUSIONS Significant predictors of survival include performance status, platelet count, histology, and degree of involvement of pleural cavity. Within the confines of this retrospective study and the small number of patients undergoing multimodality therapy, the role of surgery in the treatment of MPM remains unclear. Further investigation is warranted to determine the optimal treatment strategy in this disease.
This paper references
Pleural mesothelioma in 2002: going somewhere very slowly.
H. Pass (2002)
The pattern of lymph node involvement influences outcome after extrapleural pneumonectomy for malignant mesothelioma.
J. Edwards (2006)
Prognostic factors for mesothelioma.
J. Steele (2005)
A phase II trial of surgical resection and adjuvant high-dose hemithoracic radiation for malignant pleural mesothelioma.
V. Rusch (2001)
Resection margins, extrapleural nodal status, and cell type determine postoperative long-term survival in trimodality therapy of malignant pleural mesothelioma: results in 183 patients.
D. Sugarbaker (1999)
Prognostic factors in patients with pleural mesothelioma: the European Organization for Research and Treatment of Cancer experience.
D. Curran (1998)
The Mesothelioma epidemic in Western Europe: an update
C. Pelucchi (2004)
A proposed new international TNM staging system for malignant pleural mesothelioma. From the International Mesothelioma Interest Group.
V. Rusch (1995)
Pleural mesothelioma: little evidence, still time to do trials
T. Treasure (2004)
Prognostic factors for malignant mesothelioma in 142 patients: validation of CALGB and EORTC prognostic scoring systems
J. Edwards (2000)
Prognostic factors in malignant mesothelioma.
J. Burgers (2004)
Surgical treatment of malignant pleural mesothelioma: a review.
S. van Ruth (2003)
Radical pleurectomy/decortication and intraoperative radiotherapy followed by conformal radiation with or without chemotherapy for malignant pleural mesothelioma.
T. T. Lee (2002)
Thoracoscopy in pleural malignant mesothelioma: A prospective study of 188 consecutive patients. Part 2: Prognosis and staging
C. Boutin (1993)
Induction chemotherapy, extrapleural pneumonectomy, and radiotherapy in the treatment of malignant pleural mesothelioma: the Memorial Sloan-Kettering experience.
R. Flores (2005)
Survival patterns for malignant mesothelioma: The seer experience
R. Spirtas (1988)
A proposed new international TNM staging system for malignant pleural mesothelioma from the International Mesothelioma Interest Group.
V. Rusch (1996)
Prognostic factors in malignant mesothelioma. Lung Cancer 2004;45S1:S49—54
JA Burgers (2004)
Diffuse malignant mesothelioma of the pleura in Ontario and Quebec: a retrospective study of 332 patients.
P. Ruffié (1989)
Factors predictive of survival among 337 patients with mesothelioma treated between 1984 and 1994 by the Cancer and Leukemia Group B.
J. Herndon (1998)
Surgical management of malignant pleural mesothelioma: a systematic review and evidence summary.
D. Maziak (2005)
Thoracoscopy in pleural malignant mesothelioma: A prospective study of 188 consecutive patients. Part 1: Diagnosis
C. Boutin (1993)
Prognostic factors in mesothelioma.
J. Steele (2005)

This paper is referenced by
Coactivation of Receptor Tyrosine Kinases in Malignant Mesothelioma as a Rationale for Combination Targeted Therapy
M. Brevet (2011)
Malignant pleural mesothelioma: A retrospective analysis of clinicopathological and survival data
Azza M. Adel (2011)
Is there a role for prophylactic radiotherapy to intervention tract sites in patients with malignant pleural mesothelioma?
Paul Halford (2018)
Surgery in Malignant Pleural Mesothelioma
R. Bueno (2018)
Gene expression profiling of homologous recombination repair pathway indicates susceptibility for olaparib treatment in malignant pleural mesothelioma in vitro
Sabrina Borchert (2019)
Title Growth suppressive effect of pegylated arginase in malignantpleural mesothelioma xenografts
Sze-kwan Lam (2017)
Missed Opportunities to Counsel Patients With Malignant Pleural Mesothelioma About Causation and Potential Compensation
W. Kuschner (2012)
Re-evaluation of histological diagnoses of malignant mesothelioma by immunohistochemistry
H. Sandeck (2010)
Diagnosis of Pleural Effusions
J. M. Porcel (2013)
Inflammation-Based Prognostic Indices in Malignant Pleural Mesothelioma
D. Pinato (2012)
Epithelial membrane antigen in differential diagnosis of malignant mesothelioma, metastatic adenocarcinoma, and reactive mesothelial hyperplasia Malign mezotelyoma, metastatik adenokarsinoma ve reaktif mezotelyal hiperplazi ayirici tanisinda epitelyal membran antijeni
Sibel Arslan (2016)
Clinicopathological and Survival Characteristics of Malignant Pleural Mesothelioma: A Single-Institutional Experience
Şule Karabulut Gül (2017)
Quantitative mass spectrometry to identify protein markers for diagnosis of malignant pleural mesothelioma.
Reuben White (2019)
The Role of Complete Blood Cell Count in Prognosis—Watch this Space!
N. Rochet (2012)
Complications following radical surgery for malignant pleural mesothelioma—prevention and management
Mariano Di Martino (2018)
Symptom burden in mesothelioma patients admitted to home palliative care
S. Mercadante (2016)
ERS/EACTS statement on the management of malignant pleural effusions
A. Bibby (2018)
What's new in mesothelioma.
V. Ascoli (2018)
Malignant pleural mesothelioma treated as pulmonary tuberculosis
J. Aiyekomogbon (2016)
A Clinical, Radiographic and Laboratory Evaluation of Prognostic Factors in 363 Patients with Malignant Pleural Mesothelioma
A. C. Tanrıkulu (2010)
c-Met expression and MET amplification in malignant pleural mesothelioma.
Melanie C. Bois (2016)
Clinicopathologic and Survival Characteristics of Malignant Pleural Mesothelioma Registered in Hospital Cancer Registry
K. Najmi (2014)
Persistent lung expansion after pleural talc poudrage in non-surgically resected malignant pleural mesothelioma.
O. Rena (2015)
Prognostic nutritional index predicts outcomes of malignant pleural mesothelioma
Zhou-Hong Yao (2013)
Effects of treatment regimens on survival in patients with malignant pleural mesothelioma.
A. Abakay (2013)
Prognostic Factors According to the Treatment Schedule in Malignant Pleural Mesothelioma
Guntulu Ak (2009)
ERS/EACTS statement on the management of malignant pleural effusions
A. Bibby (2019)
Meta-analysis of survival after pleurectomy decortication versus extrapleural pneumonectomy in mesothelioma.
E. Taioli (2015)
Prognostic nutritional index predicts postoperative complications and long-term outcomes of gastric cancer.
N. Jiang (2014)
Malignant pleural mesothelioma : recognising an unmet need
Samal Gunatilake (2018)
Frequent Coamplification and Cooperation between C-MYC and PVT1 Oncogenes Promote Malignant Pleural Mesothelioma
E. Riquelme (2014)
Malignant mesothelioma: a clinical study of 238 cases.
Steven E. Haber (2011)
See more
Semantic Scholar Logo Some data provided by SemanticScholar