Malignant Pleura Mesothelioma: Clinical Perspectives (original) (raw)
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Malignant pleural mesothelioma: an epidemiological perspective
Annals of cardiothoracic surgery, 2012
This paper reviews the aetiology, distribution and projected future incidence of malignant mesothelioma. Asbestos exposure is the most thoroughly established risk factor. Debate continues regarding the relative importance of the different asbestos fibre types and the contribution of Simian virus 40 (SV40). Disease incidence varies markedly within and between countries. The highest annual rates of disease, approximately 30 case per million, are reported in Australia and Great Britain. The risk of disease increases with age and is higher in men. Time from asbestos exposure to disease diagnosis is on average greater than 40 years. Non-occupational asbestos exposures contribute an increasing proportion of disease. With the exception of the United States, incidence continues to increase. In developed countries peak incidence is expected to occur before 2030.
Journal of Thoracic Disease
The malignant pleural mesothelioma is a very aggressive tumor which is arising from mesothelial cells and is associated with asbestos exposure. It is a heterogeneous cancer that shows a complex pattern of molecular changes, including genetic, chromosomic, and epigenetic abnormalities. The malignant pleural mesothelioma is characterized by a silent and slow clinical progression with an average period of 20-40 years from the asbestos exposure phase to the start of the symptoms. Unfortunately, to date, the therapeutic options are very limited, especially if the tumor is detected late. This narrative review provides an extended overview of the present evidence in the literature regarding the epidemiology, diagnostic pathways and treatment approaches of the malignant pleural mesothelioma. The treatment of mesothelioma has evolved slowly over the last 20 years not only from a surgical point of view but also radiotherapy, chemotherapy and immunotherapy play nowadays a key role. Several surgical strategies are available ranging from extrapleural pneumonectomy to cytoreductive surgery but a multidisciplinary approach seems to be mandatory because a single approach has not proved to date to be resolutive. New non-surgical treatment options appear to be promising but the results have to be taken in account with caution because clear evidence with high-quality studies is still lacking
New Perspectives on Diagnosis and Therapy of Malignant Pleural Mesothelioma
Frontiers in oncology, 2018
Malignant pleural mesothelioma (MPM) is a rare, but severe form of cancer, with an incidence that varies significantly within and among different countries around the world. It develops in about one to two persons per million of the general population, leading to thousands of deaths every year worldwide. To date, the MPM is mostly associated with occupational asbestos exposure. Asbestos represents the predominant etiological factor, with approximately 70% of cases of MPM with well-documented occupational exposure to asbestos, with the exposure time, on average greater than 40 years. Environmental exposure to asbestos is increasingly becoming recognized as a cause of mesothelioma, together with gene mutations. The possible roles of other cofactors, such as viral infection and radiation exposure, are still debated. MPM is a fatal tumor. This cancer arises during its early phase without clinical signs. Consequently, its diagnosis occurs at advanced stages. Standard clinical therapeutic...
Tanaffos, 2014
Background: Malignant pleural mesothelioma (MPM) is a rare but fatal thoracic tumor, which in the majority of patients is caused by prolonged exposure to asbestos fibers. We aimed at presenting clinicopathological and treatment outcomes of 60 patients of MPM registered in our hospital cancer registry. Materials and Methods: Demographic characteristics of patients, exposure to asbestos, smoking habit, their clinicopathologic characteristics and survival analysis were described. Results: Sixty patients had MPM. Forty patients (66.7%) were men. The mean age of patients was 55.8±11 years. Chest pain and dyspnea were the most prevalent symptoms (31.7%, and 30%, respectively). Thirty-six (61.7%) patients reported asbestos exposure. The median survival and Progression free survival (PFS) were 10.5 months (0.95CI=9.22-11.78) and 7.57 months (0.95CI=5.68-9.45), respectively. In multivariate analysis, exposure to asbestos and epithelioid subtype significantly extended the survival time. Bilateral involvement, high blood level of LDH and platelet count ≥400,000 significantly shortened the overall survival. Conclusion: MPM is still an important health problem in Iran. Given the aforementioned results, developing a national program to eliminate asbestosrelated diseases according to the world health organization (WHO) recommendation is necessary.
Malignant pleural mesothelioma (MPM) is a relevant public health issue. A large amount of data indicate a relationship between mesothelioma and asbestos exposure. MPM incidence has considerably and constantly increased over the past two decades in industrialized countries and is expected to peak in 2010-2020. In Italy, the standardized incidence rate in 2008 was 3.6 and 1.3 per 100,000 in men and women respectively, with wide differences from one region to another. The approach to this disease remains difficult and complex in terms of pathogenic mechanism, diagnosis, staging and treatment thus an optimal strategy has not yet been clearly defined. The Second Italian Multidisciplinary Consensus Conference on Malignant Pleural Mesothelioma was held in Turin (Italy) on November 24-25, 2011: recommendations on MPM management for public health institutions, clinicians and patients are presented in this report.
Malignant Pleural Mesothelioma: Occupational and Non-Occupational Asbestos Exposures
Journal of lung, pulmonary & respiratory research, 2016
The objectives of this study was to review many epidemiological risk factors on the occurrence of malignant pleural mesothelioma among occupational and non-occupational asbestos-exposed men and women mentioned in several previous studies. Asbestos exposure is a well-documented etiological factor of malignant pleural mesothelioma. The majority of cases are men and only 40% of female cases are occupational exposure. Many western and developing countries are currently suffering malignant pleural mesothelioma epidemic due to their extensive use of asbestos. Exposure to all types of asbestos can induce malignant mesothelioma, including cancer of lung, larynx, ovary, and gastrointestinal organs, particularly, colorectal region. Approximately, 125 million people expose to asbestos in their workplaces worldwide. There are several limitations of the studies on association of the asbestos exposures, both occupational and para-occupational or nonoccupational causes, such as inability to take into account confounding by occupational asbestos exposure, difficulties in retrace past exposures, inadequacy of the length of followup, various exposure levels at different factories, and unavailability of data regarding the type of asbestos used and measurements of the airborne asbestos dust concentration in each factory. Currently, there are many governmental asbestos-use-control organizations, including malignant pleural mesothelioma database in many countries, such as The Italian
Journal of lung, pulmonary & respiratory research, 2021
Background Malignant pleural mesothelioma (MPM) is a rare primary tumor, developed from the mesothelial cells of the visceral or parietal pleura. The most frequent location is at the pleura (90% of case). The other locations being rarer: peritoneum (5 to 10% of cases), pericardium (0.4% of cases), and very rarely the tunica vaginalis testes. The incidence of this type of tumor varies from country to country in the world; in the United States, 1 the incidence is estimated at 3,200 cases / year, while in France, MPM affects around 800 to 1,000 people each year with an incidence of around 16 cases / million inhabitants / year. 2,3 It is a pathology that is mainly due to exposure to asbestos, whether or not associated with other etiopathogenicfactors. 4-6 MPM is characterized by a long latency period that can go up to 20 to 40 years. 3,7 It has a very poor prognosis with a 5-year relative survival rate of 7%, 8 and a median survival of 8 to 14 months. 9,10 Late diagnosis, the lack of an effective therapeutic approach and resistance to conventional chemotherapy make this prognosis poor. The objective of this work is to study the main epidemiological, clinical, histological and therapeutic aspects of these tumors and to compare our results with those reported in the literature. Methods In order to describe the epidemiological, clinical, histological, and therapeutic profile of patients with MPM, we conducted a descriptive retrospective study on 8 cases of MPM collected at the medical oncology department of the Hassan II University Hospital in Fez, over a period of 8 years from January 2011 to January 2019. We only included patients treated in our department, aged over 18 years with a diagnosis of MPM made after an histopathological study. Statistical analysis was done by SPSS version 23software, qualitative variables are expressed in frequency and percentage, and quantitative variables are expressed as median and mean. Results Epidemiological data Between January 2011 and January 2019, we included 8 patients with MPM in the medical oncology department of CHU Hassan II in Fez. It represents less than 0.1% of all cancers diagnosed during the study period. The mean age at diagnosis was 53 years with age ranges ranging from 26 to 80 years. There was a slight male predominance with a sex ratio M/F of 1.7. Occupational exposure to asbestos was found in a single patient, smoking was noted in 3 patients (37.5%). The concept of irradiation was not reported nor family cases of pleural mesothelioma. Clinical data All of our patients presented respiratory symptoms dominated by dyspnea (6 patients; 75%), chest pain (5 patients; 62.5%), and
Malignant pleural mesothelioma (MPM) is a very important public health issue. A large amount of data indicates a relationship between mesothelioma and asbestos exposure. The incidence has both considerably and constantly increased over the past 2 decades in the industrialized countries and is expected to peak in 2010 -2020. In Italy, a standardized-rate incidence in 2002 among men was 2.98 per 100,000 and 0.98 per 100,000 among women, with wide differences from one region to another. Stage diagnosis and definition may be difficult. Management of patients with MPM remains complex, so an optimal treatment strategy has not yet been clearly defined.
Prognostic Factors in Diffuse Malignant Pleural Mesothelioma
Chest, 1988
The existence of large shipyards accounts for the particular frequency of pleural mesothelioma in the Nantes-St.Nazaire region of France. From 1955 to 1985, 167 cases were diagnosed. Occupational exposure to asbestos was involved in 131 cases (88 percent). There was a great predominance of epithelial types (135) over mixed (25) and fibrosarcomatous (7) types. Survival, estimated by the actuarial method, was 54 percent at one year from first symptoms and 39 percent from histologic diagnosis. No subject The link between mesothelioma and exposure to asbestos accounts for the increased incidence of this pathologic condition in regions with industries using asbestos, such as shipbuilding. The Nantes-St. Nazaire area on the Loire River estuary is one of the regions in France with a high incidence of mesotheliorna.' The purpose of the present study was to note all of the cases diagnosed in the Loire-Atlantique area (comprising largely the Nantes-St. Nazaire area) between 1955 and 1985 in order to update earlier studies concerning clinical and pathologic aspects'" and to search for factors influencing prognosis. MATERIALS AND METHODS Collection of Data The list of cases was taken from the files of the Pathology Laboratory of the Nantes University Hospital. Data concerning patients were gathered retrospectively from medical files of hospital departments and specialists, and in some cases from a questionnaire sent to family doctors. The information obtained concerned the subject's sex and age, occupational history (most patients had been thoroughly questioned at the time of diagnosis), means of obtaining the samples on which the diagnosis was based and histologic type. The existence of pleural plaques suggestive of asbestosis revealed by conventional radiology, computed tomography, thoracoscopy or surgical exploration was specified. Occurrence of metastases and involvement of the contralateral hemithorax during the course of the disease were noted.
Clinical Imaging, 2006
We aimed to investigate the computed tomography (CT) findings of malignant pleural mesothelioma (MPM) caused by environmental asbestos exposure. We retrospectively reviewed CT scans of 66 patients, which were performed before any invasive procedure was done. Pleural effusion (80.3%), pleural thickening (77.2%), volume contraction (37.9%), involvement of mediastinal pleura (31.8%) and interlobar fissure (28.8%) were the most common CT findings of MPM. Although none of these findings are pathognomonic for MPM, they may provide valuable clues for the differential diagnosis, at least in patients with a history of asbestos exposure. D