General Information
Prognosis in this disease is difficult to assess consistently because there
is great variability in the time before diagnosis and the rate of disease
progression. In large retrospective series of
pleural mesothelioma patients, important prognostic factors were found to be
stage, age, performance status, and histology.[1,2] Various surgical procedures may be possible in selected patients, and they provide long-term survival without cure. For patients treated with
aggressive surgical approaches, factors associated with improved long-term
survival include epithelial histology, negative lymph nodes, and negative
surgical margins.[3,4] For those patients treated with aggressive surgical
approaches, nodal status is an important prognostic factor.[3] Median survival
has been reported as 16 months for patients with malignant pleural disease and 5 months for patients with
extensive disease. In some instances the tumor grows through the
diaphragm making the site of origin difficult to assess. Cautious
interpretation of treatment results with this disease is imperative because of
the selection differences among series. Effusions, both pleural and
peritoneal, represent major symptomatic problems for at least 66% of the
patients. (Refer to the PDQ summary on Cardiopulmonary Syndromes for more information.) A history of asbestos exposure is reported in about 70% to 80% of
all cases of mesothelioma.[1,5,6]
References
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Ruffie P, Feld R, Minkin S, et al.: Diffuse malignant mesothelioma of the pleura in Ontario and Quebec: a retrospective study of 332 patients. J Clin Oncol 7 (8): 1157-68, 1989.
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Tammilehto L, Maasilta P, Kostiainen S, et al.: Diagnosis and prognostic factors in malignant pleural mesothelioma: a retrospective analysis of sixty-five patients. Respiration 59 (3): 129-35, 1992.
[PUBMED Abstract]
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Sugarbaker DJ, Strauss GM, Lynch TJ, et al.: Node status has prognostic significance in the multimodality therapy of diffuse, malignant mesothelioma. J Clin Oncol 11 (6): 1172-8, 1993.
[PUBMED Abstract]
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Sugarbaker D, Harpole D, Healey E, et al.: Multimodality treatment of malignant pleural mesothelioma (MPM): results in 94 consecutive patients. [Abstract] Proceedings of the American Society of Clinical Oncology 14: A-1083, 356, 1995.
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Chailleux E, Dabouis G, Pioche D, et al.: Prognostic factors in diffuse malignant pleural mesothelioma. A study of 167 patients. Chest 93 (1): 159-62, 1988.
[PUBMED Abstract]
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Adams VI, Unni KK, Muhm JR, et al.: Diffuse malignant mesothelioma of pleura. Diagnosis and survival in 92 cases. Cancer 58 (7): 1540-51, 1986.
[PUBMED Abstract]
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