Patients with a rare, localized form of pleural mesothelioma may have a better survival outlook than patients with the more common, diffuse variety. That conclusion comes from a team of thoracic surgeons at Cambridge University. Their goal was to determine what, if any, difference in survival could be expected between people with localized malignant mesothelioma (LMM) of the pleura and those with standard pleural mesothelioma.
Most pleural mesothelioma patients have a type of cancer that tends to spread quickly in a sheet across the thin membrane that surrounds the lungs. While patients with LMM have identical mesothelioma cells, from a histological perspective, the growth pattern exhibited by these cells is distinctly different. Instead of spreading across the mesothelium, LMM presents as a solid tumor, in one location on the membrane.
Acknowledging that “there is an impression that localized malignant mesothelioma may have a better outcome than the commoner diffuse form of malignant mesothelioma that has been reported to have a survival between 8 and 14 months”, the Cambridge team examined the records of 150 different mesothelioma patients. Of the 150 cases reviewed, 16 represented what the research team called “the best evidence to answer the question.” While pointing out that the different papers reported treatments and results of each mesothelioma case differently, there was enough consistent data to draw some conclusions.
Among the papers that reported median survival of those with localized malignant mesothelioma, the range was 11.6 to 36 months. Among the papers that reported disease-free survival instead, the range was 0 to 11 months. Median survival to the longest follow-up was 29 months when all of the results were considered. Based on these results, the team concluded that survival in LMM is longer than that of the diffuse form of malignant mesothelioma. Their analysis supports the idea that clinicians may do well to consider more aggressive treatments for their patients with LMM.
Malignant mesothelioma is a rare cancer affecting an estimated 2,500 Americans annually. All forms of mesothelioma have been linked to asbestos exposure.