[Prognostic factors in cases of diffuse malignant pleural mesothelioma]

Among 56 cases of diffuse malignant pleural mesothelioma (including three cases from our institute and 53 reported in Japan from 1978 to 1987), we investigated several prognostic factors, such as age, sex, exposure to asbestos, smoking history, symptom duration, tuberculin skin test, localization of the lesion, pleural effusion, histologic type, metastasis, treatment and some laboratory data, concerning periods from the appearance of symptoms to death. In our series, exposure to asbestos, smoking history, localization of the lesion, pleural effusion and histologic type have no influence on the median survival from symptoms. However, the median survival from symptoms was significantly shorter in males, subjects more than 49 years of age, those having symptoms less than 6 months, those with a negative tuberculin skin test, or those with metastasis of the tumor compared with females, subjects less than 50 years of age, those having symptoms more than 6 months, those with a positive tuberculin skin test, or those without metastasis of the tumor, respectively. In subjects receiving surgery, anticancer chemotherapy, or no treatment, the fifty percent survival period was about 16, 9, or 6 months, respectively. There were, however, no significant relationships between the median survival from symptoms and the Brinkmann smoking index, or the median survival from symptoms and period of asbestos exposure.