Mesothelioma

Our plain-English summary of Mesothelioma, by W. Weder (Annals of Oncology, 2010).

The study

• Author: W. Weder
• Journal: Annals of Oncology
• Published: 2010;21 Suppl 7:vii326-33
• Type of article: Review
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

This symposium article reviewed malignant pleural mesothelioma, which the author described as associated with asbestos exposure and nearly invariably fatal once diagnosed. It summarised published research on epidemiology, molecular pathology, diagnosis, surgery, multimodality therapy, radiotherapy, imaging, chemotherapy and new treatments. A first analysis predicted that male mesothelioma deaths in Europe would peak in 2020, while more recent models placed the peak around 2015. Italian registry data showed a median latency of 44.6 years. Mutations in the NF2 gene were reported in 40% of mesotheliomas. A systematic review could not determine whether extrapleural pneumonectomy (EPP) improved survival. A retrospective analysis of 663 patients reported a median survival of 14 months. In a Swiss multicentre phase II trial of 61 patients given neoadjuvant cisplatin and gemcitabine, median survival was 19.8 months by intent to treat and 23 months after EPP. A trial of 456 patients found better response (41% versus 17%) and median survival (12.1 versus 9.3 months) with cisplatin–pemetrexed than with cisplatin alone, and this combination became the preferred regimen. The author concluded that final proof that radical surgery prolongs survival would come only from a randomized study, such as the UK MARS trial.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This 2010 symposium article by an author from the Division of Thoracic Surgery at University Hospital Zurich was a narrative review of malignant pleural mesothelioma, not a new study. It described the disease as associated with asbestos exposure and named crocidolite, amosite and tremolite among the fibers linked to it. Citing other work, it reported a median latency of 44.6 years in the Italian Mesothelioma Registry and NF2 gene mutations in 40% of mesotheliomas. It cited a 456-patient trial in which cisplatin plus pemetrexed gave better response (41% versus 17%) and median survival (12.1 versus 9.3 months) than cisplatin alone. It described the author's group's earlier Swiss trial in which 61 patients received chemotherapy with planned extrapleural pneumonectomy. Of these, 45 (74%) had the operation, and median survival was 19.8 months by intent to treat and 23 months for those operated on. The author noted that a systematic review could not determine whether this operation improves survival. The author concluded that radical surgery may be associated with longer survival than chemotherapy alone, but that final proof would only come from a randomized study.

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: Narrative review (symposium article) of published research on malignant pleural mesothelioma
• Who was studied: No study population of its own. The article reviewed published literature on malignant pleural mesothelioma, covering epidemiology, molecular pathology, diagnosis, surgery, multimodality therapy, radiotherapy, imaging, chemotherapy and new treatment approaches.
• Exposure: Asbestos exposure in general. The article named crocidolite, amosite and tremolite as fibers to which mesothelioma development is linked.
• Main results:
  • The review described malignant pleural mesothelioma as associated with asbestos exposure and stated that, once diagnosed, patients nearly invariably die of the disease.
  • Citing data from the Italian Mesothelioma Registry, the review reported a median latency of 44.6 years, increasing over time.
  • Citing earlier studies, the review reported that mutations in the NF2 gene have been found in 40% of mesotheliomas.
  • Citing a trial of 456 patients, the review reported that response was 17% with cisplatin alone versus 41% with cisplatin plus pemetrexed, and median survival was 9.3 months versus 12.1 months.
  • In the author's group's earlier Swiss multicenter phase II trial, all 61 patients received three cycles of neoadjuvant cisplatin and gemcitabine. Extrapleural pneumonectomy was performed in 45 (74%), complete resection was felt to be achieved in 37 (61%), and operative mortality was 2.2%. Median survival was 19.8 months for all patients by intent to treat and 23 months for patients undergoing extrapleural pneumonectomy.
  • The review cited a systematic review of the literature from 1985 to 2004 that could not determine whether extrapleural pneumonectomy improves survival or palliates symptoms.
  • In a retrospective analysis of 663 patients from three US centers, cited by the review, operative mortality was 7% for extrapleural pneumonectomy and 4% for pleurectomy and decortication. The author wrote that, because of selection biases and the retrospective design, no firm conclusions could be drawn without a controlled prospective trial.
• The authors' conclusion: The author concluded that published results suggest radical surgery may be associated with longer survival than chemotherapy alone, but that final proof would only come from a randomized study.

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, Pleural Mesothelioma, Asbestos Exposure, Epidemiology, Pathology, Multimodal Therapy, Chemotherapy, Latency.

Related studies

• Malignant pleural mesothelioma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up — R.A. Stahel, W. Weder, et al. (2010)
• Future developments in the management of malignant pleural mesothelioma — P.A. Zucali, F. De Vincenzo, et al. (2009)
• Different imaging methods in the assessment of radiation-induced lung injury following hemithorax irradiation for pleural mesothelioma — P. Maasilta, L. Kivisaari, et al. (1990)
• Recent advances in the treatment of malignant pleural mesothelioma — S.S. Ramalingam, C.P. Belani (2008)
• Malignant pleural mesothelioma — H.L. Kindler (2000)
• Updates in the diagnosis and treatment of malignant pleural mesothelioma — D. Katzman, D.H. Sterman (2018)

Browse more research in Annals of Oncology, or return to medical research.