Malignant mesotheliomas and chemotherapy

Our plain-English summary of Malignant mesotheliomas and chemotherapy, by C.P. Karakousis, M. Seddiq, R. Moore (Journal of Surgical Oncology, 1980).

The study

• Authors: C.P. Karakousis, M. Seddiq, R. Moore
• Journal: Journal of Surgical Oncology
• Published: 1980;15(2):181-5
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Of 77 patients with mesotheliomas, 63.6% had pleural involvement, 31.2% had peritoneal involvement, and 5.2% had involvement at other sites. The presenting symptoms varied with the location of the primary. Surgery and irradiation did not appear to influence the course of the diffuse type. Of 41 patients given systemic chemotherapy, three patients had complete response and four had greater than 50% objective response (median survival 42.5 months); 18 patients had stabilization (median 12.8 months), and 16 showed no response (median 4.5 months). The difference in survival between responders and non-responders was statistically significant (P < 0.001). Of 16 patients who received secondary chemotherapy, four had complete response (median survival 17.5 months), six had stabilization (median 10.5 months), and six had no response (median 2.5 months). Chemotherapy appears moderately effective in the treatment of mesotheliomas.

In plain English

This article described 77 patients with malignant mesothelioma treated at Roswell Park Memorial Institute in Buffalo between 1966 and 1976. The pleura was involved in 49 patients, the peritoneum in 24 and other sites in four. Sixteen patients had a history of definite asbestos exposure, 18 potential exposure, 22 no exposure and 21 undetermined. The authors reported that asbestos exposure was more directly related to pleural than to peritoneal location (P less than 0.005). Median survival for the whole group was 6.7 months. The authors judged that surgery and radiation did not appear to influence the course of the diffuse disease. Of 41 patients given chemotherapy, three had complete regression (median survival 44.5 months), four had greater than 50% objective response (41 months), 18 had stabilization lasting more than two months (12.8 months) and 16 had no response (4.5 months). The difference between responders and non-responders was reported as highly significant (p less than 0.001). The authors concluded that appreciable benefit may be experienced with systemic chemotherapy. They noted that their hospital is a referral center that tends to receive more severe cases.

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: Case series: review of patients with malignant mesothelioma treated at one cancer hospital, with outcomes by asbestos history, tumor site, surgery, radiation and chemotherapy
• Who was studied: 77 patients with malignant mesothelioma treated at Roswell Park Memorial Institute, Buffalo, 1966-1976. There were 50 males and 27 females, with a mean age of 54.1 years (range 26-83). The pleura was involved in 49 (63.6%), the peritoneum in 24 (31.2%) and other sites in 4 (5.2%).
• Exposure: Asbestos exposure history (no fiber types named): definite exposure in 16 patients (group 1), potential exposure in 18 (group 2), no exposure in 22 (group 3), undetermined in 21 (group 4). Treatments studied: surgery, radiation (28 patients) and chemotherapy (41 patients, a variety of protocols).
• Main results:
  • Asbestos exposure was more directly related to pleural location than to peritoneal location of mesotheliomas (P < 0.005). In group 1 (definite exposure), the pleura was involved in 15 of 16 patients and the peritoneum in 1.
  • Median survival of the whole group of 77 patients was 6.7 months.
  • By surgery: biopsy only, 33 patients, median survival 8.3 months; local excision, 14 patients, 5.6 months; wide excision, 8 patients, 6.0 months; no primary surgery, 22 patients, 7 months.
  • Of 28 patients given radiation, 19 had therapeutic radiation with median survival 7.5 months. Seven had complete clinical regression, two partial regression and six stabilization. The authors stated that radiation did not appear to influence the course of the disease.
  • Of 41 patients given chemotherapy: 3 had complete regression (median survival 44.5 months), 4 had greater than 50% objective response (41 months), 18 had stabilization longer than 2 months (12.8 months) and 16 had no response (4.5 months). The difference in survival between responders and nonresponders was reported as highly significant (P < 0.001).
  • 26 patients received secondary chemotherapy after the first regimen failed. Of 16 with known response, 4 had complete clinical regression (median survival 17.5 months), 6 had stabilization (10.5 months) and 6 had no response (2.5 months).
  • Four of the seven patients with complete clinical regression had been treated with the CYVADIC protocol.
  • Median survival was 13.6 months for 24 patients with peritoneal involvement and 6.0 months for 49 patients with pleural involvement (borderline significance, P < 0.10). No difference in survival was found by age group or by sex.
• The authors' conclusion: The authors concluded that mesotheliomas appeared to have a reasonable response to chemotherapy, dependent on the drug combination used. They also concluded that mesotheliomas are highly lethal but that appreciable benefit may be experienced with systemic chemotherapy.
• Limitations the authors state:
  • The authors suggested the relatively low survival may reflect that the institute is a referral center that tends to receive more severe cases.

Topics

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

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Chemotherapy, Mesothelioma, Median Survival.

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