Accuracy of diagnostic procedures in the initial evaluation and follow-up of mesothelioma patients

Our plain-English summary of Accuracy of diagnostic procedures in the initial evaluation and follow-up of mesothelioma patients, by W.F. Strankinga, M. Sperber, M.C. Kaiser, et al (Respiration; International Review of Thoracic Diseases, 1987).

The study

• Authors: W.F. Strankinga, M. Sperber, M.C. Kaiser, J. Stam
• Journal: Respiration; International Review of Thoracic Diseases
• Published: 1987;51(3):179-87
• Cited by: 7 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 001001).

Abstract

The present study contains the review of 30 patients with malignant mesothelioma of the pleura, examined and treated at our institution. In an attempt to compare various methods of diagnosis in this entity, emphasis was laid on specific abilities and limitation of investigations such as pleural biopsy, pleural fluid cytology, diagnostic thoracoscopy and thoracotomy and radiological studies including computed tomography and magnetic resonance imaging. Clinical management problems encountered in this neoplasm are also discussed.

In plain English

This was a review of 30 patients with malignant mesothelioma of the pleura who were evaluated at the Free University Hospital in Amsterdam, the Netherlands, over a 3.5-year period. The authors compared diagnostic tests. Eighteen patients had a history of asbestos exposure lasting from 6 months to 20 years. Pleural fluid cytology was done in the 25 patients who had a pleural effusion, and it did not give a definite diagnosis in any of them. Thoracoscopy with multiple biopsies gave a definite diagnosis in 19 of 24 patients (79%). All 9 patients who had a diagnostic thoracotomy were diagnosed by it. All 7 mesothelioma patients tested were negative for the marker CEA. Keratin staining did not distinguish mesothelioma from adenocarcinoma. CT was done in 17 patients and showed spread to the other side of the chest in 5 and involvement of the mediastinum in 8. MRI was done in 6 patients and showed the tumor well in all of them. Patients received only symptomatic treatment, and median survival was 12 months. The authors concluded that thoracoscopy appeared to be the most effective invasive test, with the least morbidity and mortality.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Retrospective review (case series) of patients at one hospital, comparing diagnostic methods
• Who was studied: 30 patients with malignant pleural mesothelioma (24 men) evaluated at the Free University Hospital, Amsterdam, the Netherlands, over 3.5 years
• Exposure: 18 of the 30 patients had a history of asbestos exposure, lasting 6 months to 20 years. No fiber types or jobs are given.
• Main results:
  • The 25 patients who presented with pleural effusion had pleural fluid sent for cytology, and cytology gave no definite diagnosis of mesothelioma in any of them (Table II: 25 tested, 0 positive)
  • Thoracoscopy with multiple biopsies gave a definite diagnosis in 19 of 24 patients (79%)
  • Diagnostic thoracotomy gave a positive diagnosis in all 9 patients who had it (Table II)
  • All mesothelioma patients tested for CEA (7) were negative
  • Keratin staining of frozen sections did not distinguish adenocarcinoma from mesothelioma
  • Among 17 patients who had CT, CT showed contralateral extension in 5 and mediastinal involvement in 8
  • In all 6 patients who had MRI, the tumor mass was well visualized as an area of high signal intensity
  • The 30 patients had a median survival of 12 months and all received only symptomatic treatment
• The authors' conclusion: The authors concluded that, among the invasive diagnostic tests, thoracoscopy appeared to be the most effective and to involve the least morbidity and mortality

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Mesothelioma, Pleura, Pleural Biopsy, Fluid Cytology, Thoracoscopy, Thoracotomy, Neoplasm.

Related studies

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• Historical cohort study of US man-made vitreous fiber production workers: I. 1992 fiberglass cohort follow-up: initial findings — G.M. Marsh, A.O. Youk, et al. (2001)
• 18F-FDG PET/CT in suspected recurrences of epithelial malignant pleural mesothelioma in asbestos-fibers-exposed patients (comparison to standard diagnostic follow-up) — A. Niccoli-Asabella, A. Notaristefano, et al. (2013)
• Diagnostic accuracy and safety of semirigid thoracoscopy in exudative pleural effusions in Denmark — F. Willendrup, U. Bodtger, et al. (2014)
• Malignant pleural mesothelioma: some aspects of epidemiology, differential diagnosis and prognosis. Histological and immunohistochemical evaluation and follow-up of mesotheliomas diagnosed from 1964 to January 1985 — R. Walz, H.K. Koch (1990)
• Comparison of the diagnostic accuracy of the MSLN gene products, mesothelin and megakaryocyte potentiating factor, as biomarkers for mesothelioma in pleural effusions and serum — J. Creaney, S. Sneddon, et al. (2013)

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