[Malignant mesothelioma: study of prognostic factors in a series of 188 cases]

From 1973 to 1990, 188 patients with pleural malignant mesothelioma entered a prospective study of this disease to assess the main prognostic factors. All had undergone thoracoscopy with endoscopic description of lesions, and multiple biopsies. The diagnostic yield of thoracoscopy was 98.4%. Multivariate analysis of main clinical, histopathological, endoscopic and radiological (including CT-scan) parameters was performed according to Cox's model. The most favorable factors were: absence of weight loss at the time of diagnosis, absence of involvement of the visceral pleural, Butchart stage I and epithelial histopathological type. Thoracoscopy allowed early diagnosis of the disease and a subdivision of Butchart stage I into stage IA (with normal visceral pleura) and stage IB (with invaded visceral pleural): median survivals are 32.7 and 7 months respectively. Like CT scan, thoracoscopy is therefore necessary in the staging of malignant mesothelioma.