Mesothelioma and asbestos-related pleural diseases

Our plain-English summary of Mesothelioma and asbestos-related pleural diseases, by L. Greillier, P. Astoul (Respiration; International Review of Thoracic Diseases, 2008).

The study

• Authors: L. Greillier, P. Astoul
• Journal: Respiration; International Review of Thoracic Diseases
• Published: 2008;76(1):1-15
• Type of article: Review
• Cited by: 33 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

At present, the use of asbestos is not regulated at a worldwide scale. Moreover, there is a latency period between asbestos exposure and the manifestations of asbestos-related diseases. Consequently, pulmonologists are still dealing with consequences of asbestos exposure, which mainly occur at the pleural surface. The aim of this review is to provide an overview of asbestos-related pleural diseases. We summarized the most relevant data for the diagnosis and the management of benign asbestos pleural effusions, pleural plaques, diffuse pleural thickening and rounded atelectasis. Special attention is dedicated to malignant pleural mesothelioma, given the challenging issues of this disease, the recent advances in its management and the dynamism of research in this area.

2008 S. Karger AG, Basel.

In plain English

This article was a narrative review of asbestos-related diseases of the pleura, the lining around the lungs. It did not collect new data; the figures it gives come from earlier studies it cites. It covered four non-cancerous conditions (benign asbestos pleural effusion, pleural plaques, diffuse pleural thickening and rounded atelectasis) and malignant pleural mesothelioma. It left out asbestosis and lung cancer. Drawing on the cited studies, the authors wrote that pleural plaques do not turn into mesothelioma and do not increase the risk of asbestos-related cancer, but they are markers of asbestos exposure. They also wrote that amphibole fibers are much more likely than chrysotile fibers to cause mesothelioma, and that untreated mesothelioma has a median survival of 4 to 12 months. They described a cited trial in which patients given pemetrexed plus cisplatin had a median survival of 12.1 months, compared with 9.3 months for patients given cisplatin alone. The authors concluded that the benign diseases generally need no specific treatment, while mesothelioma has a poor prognosis and a rising incidence in many countries.

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 of published literature (no new data collected)
• Who was studied: No study population; the review covered published research on five asbestos-related pleural diseases, excluding asbestosis and lung cancer
• Exposure: Asbestos in general. The review describes serpentine fibers (chrysotile) and amphibole fibers (crocidolite, amosite, tremolite, anthophyllite, actinolite).
• Main results:
  • Citing earlier studies, the authors stated that pleural plaques do not become malignant pleural mesothelioma and that their presence does not increase the risk of asbestos-related malignancy, though plaques are markers of asbestos exposure
  • Citing earlier studies, the authors stated that amphibole fibers are much more likely than chrysotile fibers to cause malignant pleural mesothelioma
  • Citing earlier studies, the authors reported a mean latency period of 40 years or more for malignant pleural mesothelioma
  • Citing earlier studies, the authors reported a median overall survival of 4 to 12 months for untreated malignant pleural mesothelioma
  • In a cited phase III trial (Vogelzang et al.; 226 patients on pemetrexed plus cisplatin, 222 on cisplatin alone), median survival was 12.1 months in the combination group versus 9.3 months in the cisplatin-alone group (p = 0.02)
  • In a cited study (Epler et al.), benign asbestos pleural effusion occurred at 9.2, 3.9 and 0.7 effusions per 1,000 person-years after heavy, moderate and mild asbestos exposure respectively
• The authors' conclusion: The authors concluded that benign asbestos-related pleural diseases are well known and generally do not need specific treatment, whereas malignant pleural mesothelioma has a poor prognosis and an increasing incidence in many countries

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis, Mesothelioma, Pleural plaques and thickening.

Medical terms in this study, explained in our Lexicon: Mesothelioma, Asbestos-Related Pleural Disease, Latency, Asbestos Exposure, Benign Asbestos Pleural Effusion, Pleural Plaques, Diffuse Pleural Thickening, Rounded Atelectasis.

Related studies

• Diagnosis and initial management of nonmalignant diseases related to asbestos — American Thoracic Society (2004)
• Asbestos-related pleural disease and asbestosis: a comparison of CT and chest radiography — A.C. Friedman, S.B. Fiel, et al. (1988)
• Asbestos: when the dust settles an imaging review of asbestos-related disease — H.D. Roach, G.J. Davies, et al. (2002)
• Clinical value of fluorodeoxyglucose-positron emission tomography/computed tomography in differentiation of malignant mesothelioma from asbestos-related benign pleural disease: an observational pilot study — H. Yildirim, M. Metintas, et al. (2009)
• Conventional and high resolution computed tomography in the diagnosis of asbestos-related diseases — D.A. Lynch, G. Gamsu, et al. (1989)
• Asbestos-related benign pleural disease — C. Peacock, S.J. Copley, et al. (2000)

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