Malignant Pleural Mesothelioma: Timeline and Analysis of 70 Cases

Malignant pleural mesothelioma is a severe cancer linked to asbestos exposure. It often appears decades after exposure. The disease’s early symptoms are unclear, making it hard to diagnose early.

Despite being rare, this cancer is a major health concern. It has a poor prognosis and few treatment options. A new article details the study of 70 cases at Getafe University Hospital from 2008 to 2021.

Study Overview

The study aimed to detail key aspects of malignant pleural mesothelioma. It covered clinical, histological, radiological, and treatment features. The hospital’s Ethics and Research Committee approved it. The sample involved 70 patients, mainly elderly males with an average age of 71.

Asbestos exposure was found in 61% of cases. Common symptoms were shortness of breath (59%), chest pain (53%), cough (37%), and weight loss (23%).

Primary diagnostic methods included thoracoscopy (59%), image-guided pleural biopsy (21%), thoracotomy (17%), and thoracentesis (4%). Staging showed 50% were in Stage I, 9% in Stage II, 16% in Stage III, and 25% in Stage IV.

Histological analysis revealed 73% had the epithelioid subtype, 14% mixed, and 13% sarcomatoid. Treatments included chemotherapy with carboplatin and pemetrexed (73%), palliative care (16%), and surgery with pleurectomy-decortication (11%). Pleurodesis was done in 30% of patients.

Survival Rates and Prognostic Factors

The study found the group’s median survival was 10 months. Different treatments led to varied outcomes. Surgery resulted in 17 months. Chemotherapy, 10 months. Palliative care, 3 months. Patients with the epithelioid subtype fared better than those with sarcomatoid or mixed subtypes.

Multimodal therapy combines surgery, chemotherapy, and radiation. This improves outcomes. For malignant pleural mesothelioma, it often involves EPD and HITHOC. EPD removes the diseased pleura and other tissues. HITHOC is then applied to the chest to kill remaining cancer cells.

Key Findings

The study found a high rate of malignant pleural mesothelioma in Getafe, Spain. This is due to past asbestos exposure in local industries. Common symptoms were breathing difficulty and chest pain. However, these were not specific to the disease.

Diagnosing the illness was best done through thoracoscopy and CT-guided biopsy. The epithelioid type had a better outlook, especially if fully removed. Unfortunately, advanced stages and the sarcomatoid type led to worse outcomes.

However, the study had limitations. It only focused on one center. It also used retrospective data, which could introduce biases. Clinical recommendations also changed over time, potentially affecting the study’s findings. This restricts how widely the results can be applied.

Malignant Pleural Mesothelioma

The study shows how asbestos exposure raises pleural mesothelioma rates. It stresses early detection and thorough treatment. Multimodal therapy, including surgery, chemo, and radiation, boosts survival odds, especially for early-stage patients. More research and joint registries are crucial for managing the disease.

Understanding the disease’s progression and treatment options helps patients and healthcare providers. It allows for informed decisions, better outcomes, and improved quality of life for those with the disease.

Source:

Garcia-Prieto, Fernando, Sara Calero Pardo, María Teresa Río Ramírez, and Araceli Abad Fernández. “Malignant Pleural Mesothelioma: Analysis of 70 Cases in the Last Decade.” Open Respiratory Archives 6, no. 2 (April 1, 2024): 100326. https://doi.org/10.1016/j.opresp.2024.100326.