Mesothelioma: current perspectives

Our plain-English summary of Mesothelioma: current perspectives, by R.A. Taylor, L.P. Johnson (The Western Journal of Medicine, 1981).

The study

• Authors: R.A. Taylor, L.P. Johnson
• Journal: The Western Journal of Medicine
• Published: 1981;134(5):379-83
• Cited by: 14 articles, as counted by NIH iCite
• Read it: PubMed · Free full text
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 002021).

Abstract

Thirty patients with the diagnosis of mesothelioma were admitted to the Swedish Hospital Medical Center, Seattle, from 1975 to 1979. Of these, 26 had pleural and 4 had peritoneal mesothelioma. In 20 of the patients with pleural mesothelioma, the diagnosis had been made by open thoractomy and in only one by needle biopsy of the pleura. The average survival of the patients with pleural tumors from time of diagnosis was 15 months, and two are alive at three and eight months, respectively, one of whom had an apparent solitary benign mesothelioma. The average survival of those with peritoneal mesothelioma was ten months, although one has survived six years. There were 17 patients with a known history of exposure to asbestos, 14 while working in shipyards. Because of the relatively high incidence of this previously rare tumor in the Puget Sound, Washington, area, and the generally dismal results of therapy, better methods of diagnosis including thoracoscopy and a more systematic approach to treatment are recommended.

In plain English

This article reviewed 30 patients with tissue-diagnosed mesothelioma admitted to a Seattle hospital from 1975 to 1979. Twenty-five had diffuse malignant pleural, four peritoneal and one benign localized pleural mesothelioma. Of the 25 malignant pleural cases, 15 had known asbestos exposure, 13 of them in shipyards. Their average interval from exposure to diagnosis was 32 years. Two of the four peritoneal patients had known asbestos exposure. The benign-tumor patient had none. Thoracotomy gave the diagnosis in 19 of the 25 malignant pleural patients. Cytology and needle biopsy were not productive, but thoracoscopy was used successfully in two patients. Average survival after malignant pleural diagnosis was 15 months. Chemotherapy (15 patients) did not appear to significantly alter the disease, and radiotherapy (seven patients) appeared of little benefit. Of the peritoneal patients, two died two weeks after diagnosis and one after nine months. The fourth, a woman, was alive without recurrence six years later. The authors wrote that the series bore out the strong relationship of pleural mesothelioma to asbestos exposure. They recommended better methods of diagnosis, including thoracoscopy, and a more systematic approach to treatment.

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 case series (review of patients treated at one hospital)
• Who was studied: 30 patients with mesothelioma admitted to the Swedish Hospital Medical Center, Seattle, 1975 to 1979: 25 with diffuse malignant pleural mesothelioma, 4 with peritoneal mesothelioma and 1 with a benign localized pleural mesothelioma
• Exposure: Asbestos exposure, mostly in shipyards. Fiber types were not named. Among the 25 malignant pleural patients, 15 had known exposure, 13 of them in shipyards. Among the 4 peritoneal patients, 2 had known exposure, one of them in shipyards 25 years earlier.
• Main results:
  • In the malignant pleural mesothelioma patients, the average interval from time of exposure to diagnosis was 32 years.
  • Two of the four peritoneal mesothelioma patients had a known history of asbestos exposure. One of them had worked in shipyards 25 years earlier.
  • The patient with the benign localized pleural mesothelioma had no history of asbestos exposure.
  • Pleural effusion was present in 20 of the 25 malignant pleural mesothelioma patients.
  • In 19 of the 25 diffuse malignant pleural patients the diagnosis was made by thoracotomy (Table 2). The benign tumor was also found during thoracotomy.
  • Blind needle biopsy of the pleura and cytology of pleural fluid were not productive in this series.
  • Thoracoscopy was used successfully with minimal morbidity in two patients.
  • Average survival after diagnosis for the 25 diffuse pleural mesothelioma patients was 15 months.
  • One pleural patient, treated by total pleurectomy, survived five years without recurrent tumor but then died of a primary adenocarcinoma of the lung.
  • Chemotherapy, given to 15 pleural patients, did not appear to significantly alter progression of the disease.
  • Radiotherapy appeared to be of little benefit in seven pleural patients.
  • Among the peritoneal patients, two died two weeks after diagnosis and a third after nine months.
  • The fourth peritoneal patient, a woman treated by resection, radiation and chemotherapy, was alive six years after diagnosis with no evidence of recurring disease.
  • The authors stated that the series bore out the strong relationship of pleural mesothelioma to asbestos exposure.
• The authors' conclusion: The authors pointed to the relatively high incidence of mesothelioma in the Puget Sound area and the generally dismal results of therapy. They recommended better methods of diagnosis, including thoracoscopy, and a more systematic approach to treatment.
• Limitations the authors state:
  • The authors noted that, as in other series, treatment in their series represented a somewhat heterogeneous approach to therapy by a number of physicians.

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: Mesothelioma, Peritoneal Mesothelioma, Pleural Mesothelioma, Needle Biopsy, Pleura, Thoracoscopy.

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