Diffuse malignant pleural mesotheslioma at CAMC: a retrospective study of 50 patients

The cases of 50 patients who were treated for pleural diffuse malignant mesothelioma at Charleston Area Medical Center from 1966-1992 were reviewed retrospectively. Diagnosis was most often made by thoracoscopy or exploratory thoracotomy; pleural cytology was rarely contributory. The delay in diagnosis was often long (median time, 2.5 months; range 1-12 months). The median survival was only 6 months. Six clinical variables were analyzed for prognostic significance. Multivariate analysis showed that stage of disease, age, histology, and smoking history were the most important prognostic factors. Previous asbestos exposure was found in 74% of the patients. There was no cure of mesothelioma, and we did not find any significant differences in survival among groups of patients subjected to the different therapeutic measures. If new active therapies are identified, it would be useful to compare them to a best supportive care arm in order to demonstrate the value of any new therapeutic approach.