Malignant pleural mesothelioma in western Glasgow 1980-6.

Abstract

This study reviews all histologically proved cases ofmalignant pleural mesothelioma seen in the western district of Glasgow during 1980-6. Sixty eight cases were identified (three female) with an age range at presentation of48-85 (mean 68-9) years. Asbestos exposure was identified in 54 (80%) ofthe patients, most ofwhom had been shipyard workers. Pain and dyspnoea were the most common presenting symptoms. Pleural effusion was found in 57 (84%) of the patients, in a ratio of 2-6 right:left. The median survival was only 30 weeks from the time of presentaton. Prognosis was significantly better for those presenting with dyspnoea than for those with pain (median survival 44 v 22 weeks). Postmortem examination was performed in 40 cases and metastatic disease found in more than three quarters. There was no significant difference between the incidence of the various tumour cell types or any relation between cell type and survival or the incidence of metastatic disease. A substantial increase in cases of malignant pleural mesothelioma has been found in an area of already high incidence. The use of rigorous histological criteria to determine histological cell type has shown that this previously valued variable is of no discriminatory value with regard to disease activity or survival.

Diagnosis and Prognostic Factors in Malignant Pleural Mesothelioma: A Retrospective Analysis of Sixty-Five Patients

“…The same trend has been noted in other industrialized countries [2,3]. Because there is a latent period of up to 40 years from asbestos ex posure to the development of clinical disease, a significant increase in the incidence of mesothelioma is expected dur ing the coming decades [4], of the peculiar and characteristic growth pattern.…”

Survival after conservative (palliative) management of pleural malignant mesothelioma

“…Although some investigators have not found a relationship between mesothelioma histological subtype and survival [8,13,14], there are no reports of the sarcomatous subtype having a better prognosis. Taken together, the published survival data supports our ®nding of longer survival in patients with the epithelial mesothelioma subtype.…”

Survival from malignant mesothelioma: where are we now?

“…3 A paucity of older studiesprior to widespread introduction of more rapid diagnostic tools and advances in chemotherapy regimes -have reported survival data, [4][5][6] with median prognosis considered to be 8-14 months following diagnosis. 4,[7][8] Specific clinical and laboratory prognostic factors have not been exhaustively evaluated in recent years, although the sarcomatoid subtype generally heralds a poor prognosis. 8 Prognosis and prognostic factors in one locality -especially with different degrees and types of asbestos exposure -may not necessarily be assumed to be the same in others and uncertainty must therefore exist when attempts are made to anticipate survival from patient to patient and from one geographical area to the next.…”