[Malignant pleural mesothelioma: diagnosis, therapy and prognosis]

Clinical and radiological signs in 44 patients with a malignant mesothelioma of the pleura are described. 18 patients underwent radical pleuropneumonectomy with total resection of the ipsilateral diaphragma. In addition to mediastinal nodes were resected in eight cases, in three patients parts of the thoracic wall had to be removed, and in six patients partial resection of the pericardium was performed. In 15 patients (34%) palliative tumor resection was performed and in ten other persons an exploratory thoracotomy and palliative tumor resection. One patient is alive 13 years after radical pleuropneumonectomy. The mean survival time of the patients who died is after radical pleuropneumonectomy 20 months (0.2 to 54 months), after radical pleuropneumonectomy with pericardial resection 8.5 months (3 to 16 months), after palliative resection 9.7 months (0.5 to 29 months) and after exploratory thoracotomy 6.5 months (0.5 to 19 months). Three patients died within a month (6.9%), one after a radical pleuropneumonectomy, one after a palliative resection and one after an exploratory thoracotomy. The first patient died in the late sixties due to a postoperative aspiration, the other two due to tumor progression. We conclude that the radical pleuropneumonectomy can contribute to a better prognosis of the malignant pleural mesothelioma.