Clinicopathologic studies on mesothelioma of the pleura. Differentiated approach to treatment

Our plain-English summary of Clinicopathologic studies on mesothelioma of the pleura. Differentiated approach to treatment, by S. Larsson, B.M. Philipson, L. Dernevik, et al (Scandinavian Journal of Thoracic and Cardiovascular Surgery, 1988).

The study

• Authors: S. Larsson, B.M. Philipson, L. Dernevik, L. Zettergren
• Journal: Scandinavian Journal of Thoracic and Cardiovascular Surgery
• Published: 1988;22(1):65-72
• Cited by: 3 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. 000242).

Abstract

A surgical series of 23 patients with pleural mesothelioma is reviewed. Three who had benign localized mesothelioma of fibrous type are alive and well at least 10 years postoperatively. In two others, radically extirpated localized mesothelioma was histologically classified as benign, but later proved to be malignant, causing death from recurrent disease 27 and 79 months postoperatively. Four patients with diffuse malignant mesothelioma underwent pleurectomy or open biopsy and survived for 2-9 months. Radical en-bloc pleuropneumonectomy was performed on 14 patients with diffuse malignant mesothelioma. One patient died postoperatively and the others succumbed to the disease after 3-51 (mean 20) months. The survival time was greater than or equal to 1 year in 62% of the patients and greater than 3 years in 23%. Patient age, histologic tumour type and extent of disease seemed to be important prognostic factors. Despite the generally poor prognosis, the results of radical surgery in this study appear to warrant an aggressive approach to treatment of benign or localized malignant pleural mesothelioma, and possibly also to stage I diffuse malignant mesothelioma of epithelial type.

In plain English

This article reviewed 23 patients operated on for pleural mesothelioma in Gothenburg, Sweden, in 1957-1977 (18 men, 5 women; mean age 56). The article did not report the patients' asbestos exposure. Three patients with benign localized fibrous mesothelioma were alive and well after a mean follow-up of almost 11 years. Two localized tumours first reported as benign later proved malignant, and both patients died. Four patients with diffuse malignant mesothelioma who had only a biopsy or pleurectomy all died, with a mean survival of 7 months. Of 14 who had radical pleuropneumonectomy (removal of the lung together with the pleura), one died soon after surgery. Excluding that death, mean survival was 20 months (range 3-51), and 62%, 38% and 23% were alive at 1, 2 and 3 years. No patient in the series was cured. Age, stage and tumour type seemed to be important prognostic factors. The authors concluded that surgery with curative intent should be considered for stage I epithelioid tumours, but not for fibrous or biphasic diffuse tumours or more advanced stages.

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 of a surgical case series, including re-examination of all tissue specimens
• Who was studied: 23 patients with pleural mesothelioma operated on at the Department of Thoracic Surgery in Gothenburg, Sweden, 1957-1977. They were chosen from 32 patients explored for suspected pleural malignancy. There were 18 men and 5 women, with a mean age of 56 years (range 35-70).
• Main results:
  • Group 1: all 3 patients with benign localized mesothelioma were alive and well, without recurrence, after a mean postoperative observation time of almost 11 years.
  • Group 2: two localized tumours first reported as benign (one with high malignant potential) proved malignant, and both patients died. The text gives survival times of 27 and 29 months; Table II lists 27 and 79 months.
  • Group 3: all 4 patients with diffuse malignant mesothelioma who had only open biopsy or pleurectomy died. Their mean survival was 7 months, and none survived a year.
  • Group 4: of the 14 patients who had radical pleuropneumonectomy, one died early after the operation.
  • Group 4, excluding the operative death: mean survival was 20 months (range 3-51). Survival at 1, 2 and 3 years was 62%, 38% and 23%.
  • Within Group 4, mean survival was 24 months for the epithelial type and 16 months for the biphasic type.
  • All patients with diffuse malignant mesothelioma died of thoracic progression of the disease. Seven also had abdominal spread.
  • Among patients with diffuse malignant mesothelioma, patient age, stage of disease and histologic tumour type seemed to be important prognostic factors.
  • No patient in the series was cured.
• The authors' conclusion: The authors concluded that surgery with curative intent should be considered for stage I epithelioid diffuse mesothelioma. In their view, patients with fibrous or biphasic diffuse tumours, or more advanced stages, have a gloomy prognosis and should not be operated on.

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 Mesothelioma, Localized Malignant Mesothelioma, Biopsy, Prognosis.

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