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Diffuse, mixed malignant pleural mesothelioma

R J Lewis, G E Sisler, J W Mackenzie

    The Annals of Thoracic Surgery
    |January 1, 1981
    PubMed
    Summary
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    Malignant pleural mesothelioma, often linked to asbestos exposure, is typically unresectable. Minimal diagnostic procedures are recommended over aggressive surgical resection for this diffuse cancer.

    Area of Science:

    • Oncology
    • Thoracic Surgery
    • Environmental Medicine

    Background:

    • Malignant pleural mesothelioma is a rare, aggressive cancer primarily linked to asbestos exposure.
    • This study retrospectively analyzed 46 patients diagnosed with diffuse, mixed malignant pleural mesothelioma between 1970 and 1979.

    Observation:

    • Diagnosis was confirmed via thoracentesis, thoracoscopy, thoracotomy, and minithoracotomy.
    • Mediastinoscopy and bronchoscopy yielded limited diagnostic value.
    • Patients receiving no definitive therapy survived an average of 9.1 months.

    Findings:

    • Chemotherapy in 31 patients resulted in an average survival of 9.6 months.
    • Surgical resection attempts in 5 patients with apparent early disease showed poor outcomes, with 4 deaths and an average survival of 6.75 months.

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  • Complete resection was only possible in 2 patients.

    • Implications:

    • Diffuse, mixed malignant pleural mesothelioma is considered unresectable due to its multicentric origin and invasive nature.
    • Aggressive surgical resection is not indicated; the least invasive diagnostic procedure is recommended.
    • Further prospective studies are needed to establish definitive treatment protocols.