National Cancer Institute®
Last Modified: March 1, 2002
UI - 11836665
AU - Britton M
TI - The epidemiology of mesothelioma.
SO - Semin Oncol 2002 Feb;29(1):18-25
AD - Department of Respiratory Medicine, Ashford and St Peter's Hospitals NHS Trust, Chertsey, Surrey, UK.
It has been more than 40 years since occupational crocidolite exposure in South African miners was found to be associated with development of malignant mesothelial tumors 30 to 40 years later. Similar cases were not seen in the amosite and chrysotile miners. Since then, epidemiological and toxicological knowledge have increased enormously, but mortality continues to rise steeply (5% to 10% per year) in most industrialized countries. Even with widespread asbestos abatement efforts, this increase is likely to continue in Western Europe and the United State well into the next century, at least until 2020. Unregulated use of asbestos in less industrialized countries may cause the epidemic to continue throughout the next century in those regions. Asbestos abatement seems to be successful as evidenced by a decline in the proportion of patients with peritoneal tumors, which are the most common malignancies in heavily exposed individuals. Whereas in the 1960s peritoneal tumors comprised up to 30% of the total, in recent years the proportion has fallen to about 10%, This changing ratio could also be due to the steady increase in pleural tumors. The difficulty in formulating the connection as to the etiology of mesothelioma resulted from an unforeseeable difference in the carcinogenicity of various asbestos and mineral fiber types and was compounded by the very long latency of the disease. Unfortunately, the use of a single term, "asbestos," to describe at least five fibrous silicate minerals, each with unique physical, chemical, and biological properties and not infrequently and naturally admixed, severely hampered scientific investigation into the occupational health risks. The field became confused and filled with debate. At the heart of the fiber type controversy lies a fundamentally differing view of the importance of biopersistence of various asbestos fibers in carcinogenesis. This review will deal with the epidemiology of mesothelioma with particular attention to the studies that elucidate the impact of various asbestos fiber types on the etiology of the disease. Copyright 2002 by W.B. Saunders Company.
UI - 11836666
AU - Marom EM; Erasmus JJ; Pass HI; Patz EF Jr
TI - The role of imaging in malignant pleural mesothelioma.
SO - Semin Oncol 2002 Feb;29(1):26-35
AD - Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA.
Imaging plays an essential role in the diagnosis, staging, and follow-up of patients with malignant pleural mesothelioma (MPM). The diagnosis is often suggested by a unilateral pleural mass with a moderate to large pleural effusion seen on chest radiographs, but computerized tomography (CT) is the most frequently used technique for evaluation of the lungs in patients with MPM. CT not only suggests pulmonary metastases typically manifested as nodules or masses, but also can demonstrate underlying lung disease often caused by prior asbestos exposure. Magnetic resonance (MR) imaging may be helpful in selected patients with potentially resectable disease to further examine the local extent of tumor. Imaging with positron emission tomography (PET) using the radionuclide imaging agent (18)F fluoro-deoxyglucose (FDG) takes advantage of a basic property of tumor cells, increased glucose metabolism to identify malignant lesions. PET provides not only anatomic information, especially regarding mediastinal node metastasis, but also biochemical information about the lesion. These imaging modalities help triage patients to the most appropriate diagnostic and treatment options. Following patients after therapy usually relies on chest radiographs, although CT can more accurately describe response to therapy. This review will focus on radiologic evaluation in diagnosing, staging, and follow-up patients with MPM. Copyright 2002 by W.B. Saunders Company.
UI - 11836667
AU - Steele JP
TI - Prognostic factors in mesothelioma.
SO - Semin Oncol 2002 Feb;29(1):36-40
AD - Department of Medical Oncology, St Bartholomew's Hospital, London, England.
Prognostic factors in oncology may help physicians give their patients a prognosis for their disease and thus allow them to make plans for the future. These factors also assist in the selection of patients more likely to benefit from intensive treatments, especially in the context of clinical trials. Recently it has become clear that prognostic factors may have an additional benefit: they may provide insight into the biology of the cancer being studied and lead to improved understanding of the molecular pathogenesis. For malignant mesothelioma, the prognostic scoring systems of the Cancer and Leukemia Group B (CALGB) and European Organization for Research and Treatment of Cancer (EORTC) are the most useful of those currently available. These systems rate performance status, age, histological subtype, weight loss, and hematological parameters as the best prognostic factors for malignant mesothelioma. In the future, biological markers may provide additional information on mesothelioma and will help in prognostication. Copyright 2002 by W.B. Saunders Company.
UI - 11836668
AU - Zellos LS; Sugarbaker DJ
TI - Multimodality treatment of diffuse malignant pleural mesothelioma.
SO - Semin Oncol 2002 Feb;29(1):41-50
AD - Department of Surgery, Division of Thoracic Surgery, Brigham and Women's Hospital, Boston, MA 02115, USA.
Diffuse malignant pleural mesothelioma (DMPM) is a challenging disease in all of its aspects, from presentation and diagnosis to staging and treatment. Single-modality therapy was the initial approach to this disease. It generally has not been effective in changing the natural history of DMPM. As a result, multimodality regimens involving surgery with radiation, chemotherapy, or immunotherapy delivered regionally or systemically have been evaluated. Randomized controlled studies comparing various strategies are lacking and, thus, the debate continues regarding the effectiveness of different treatment approaches. Copyright 2002 by W.B. Saunders Company.
UI - 11836669
AU - Sugarbaker PH; Acherman YI; Gonzalez-Moreno S; Ortega-Perez G; Stuart
TI - OA; Marchettini P; Yoo D Diagnosis and treatment of peritoneal mesothelioma: The Washington Cancer Institute experience.
SO - Semin Oncol 2002 Feb;29(1):51-61
AD - Washington Cancer Institute, Washington, DC 20010, USA.
Peritoneal mesothelioma is a rare disease, but increasing in frequency. The incidence is approximately one per 1,000,000 and about one fifth to one third of all mesotheliomas are peritoneal. Because of its unusual nature, the disease has not been clearly defined either in terms of its natural history, diagnosis, or management. This article reviews a single institution's experience with 51 patients prospectively treated over the past decade with increasingly aggressive local/regional protocols. Peritoneal mesothelioma patients generally present with two types of symptoms and signs; those with abdominal pain, usually localized and related to a dominant tumor mass with little or no ascites and those without abdominal pain, but with ascites and abdominal distention. Pathologically, a positive immunostain for calretinin has markedly increased the accuracy of diagnosis. Prognosis as determined by clinical presentation, the completeness of cytoreduction, and gender (females survive longer than males) appears to be improved by the use of intraperitoneal chemotherapy. Over the past decade, the management of these patients has evolved similarly to ovarian cancer treatment and now involves cytoreductive surgery, heated intraoperative intraperitoneal chemotherapy (HIIC) with cisplatin and doxorubicin, and early postoperative intraperitoneal paclitaxel. These perioperative treatments are followed by adjuvant intraperitoneal paclitaxel and second-look cytoreduction. Prolonged disease-free survival and reduced adverse symptoms with the current management strategy are documented by a high complete response rate as assessed by a negative second-look. This multimodality treatment approach with cytoreductive surgery and intraperitoneal chemotherapy has resulted in a median survival of 50 to 60 months. Peritoneal mesothelioma is an orphan disease that is treatable with expectations for "potential" cure in a small number of patients if diagnosed and treated early with definitive local/regional treatments. A prolonged high quality of life is possible in the majority of patients. Copyright 2002 by W.B. Saunders Company.
UI - 11836670
AU - Baas P
TI - Chemotherapy for malignant mesothelioma: from doxorubicin to vinorelbine.
SO - Semin Oncol 2002 Feb;29(1):62-9
AD - Department of Thoracic Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
It has been a challenge to find effective chemotherapeutic treatments for malignant mesothelioma. Over the last several decades numerous single-drug and combination regimens have been examined, but no standard treatment with chemotherapy alone has emerged. Possible explanations for this lack of success are the heterogeneity between the different subclasses of mesothelioma and the difficulties experienced in determining responses on computed tomographic (CT) scan. This review will present the results of most chemotherapy trials. An attempt is also been made to overcome the problem of identifying the overall response rate by presenting the median survival time. Other types of response evaluation and guidelines for patient selection are warranted to properly compare chemotherapeutic treatments. Copyright 2002 by W.B. Saunders Company.
UI - 11836671
AU - Kindler HL; van Meerbeeck JP
TI - The role of gemcitabine in the treatment of malignant mesothelioma.
SO - Semin Oncol 2002 Feb;29(1):70-6
AD - Section of Hematology/Oncology, University of Chicago, Chicago, IL 60637, USA.
Gemcitabine is broadly active in a variety of solid tumors, including malignant mesothelioma. In vitro, gemcitabine demonstrates activity against mesothelioma cell lines. The role of single-agent gemcitabine in patients with mesothelioma is unclear, since three phase II trials treated a total of 60 patients and achieved response rates of 0%, 7%, and 31%. The combination of gemcitabine and cisplatin is synergistic against mesothelioma cell lines in vitro. Gemcitabine in combination with cisplatin or carboplatin shows definite activity in phase II trials. The trial by Byrne and colleagues that demonstrated a response rate of 48% established the combination of gemcitabine plus cisplatin as a standard therapy for this disease in the United States. Subsequent multicenter trials have achieved lower response rates of 26% and 16% for this combination. Gemcitabine plus carboplatin also has activity. Future roles for gemcitabine in malignant mesothelioma patients include incorporating a gemcitabine/platinum regimen for neoadjuvant or adjuvant therapy, combining it with other cytotoxic chemotherapy agents such as pemetrexed or vinorelbine, or adding novel cytostatic agents such as the vascular endothelial growth factor (VEGF) inhibitor, bevacizumab, to the gemcitabine and platinating agent combination. Copyright 2002 by W.B. Saunders Company.
UI - 11836672
AU - Fizazi K; John WJ; Vogelzang NJ
TI - The emerging role of antifolates in the treatment of malignant pleural mesothelioma.
SO - Semin Oncol 2002 Feb;29(1):77-81
AD - Institut Gustave Roussy, Villejuif, France.
Clinicians have long regarded malignant pleural mesothelioma as a chemoresistant neoplasm and as a result no standard chemotherapy regimen has emerged. Antifolates such as methotrexate are among the most active compounds in mesothelioma, albeit based only on phase II data. Recently two antifolate-based combinations with apparently higher efficacy than older regimens have emerged: the pemetrexed/cisplatin regimen and the raltitrexed/oxaliplatin regimen. In two phase I trials with pemetrexed combined with either cisplatin or carboplatin responses occurred in five of 11 and nine of 29 patients, respectively. In a phase I trial of raltitrexed/oxaliplatin, six of 17 patients (35%) with mesothelioma achieved a partial response. In a phase II trial of raltitrexed/oxaliplatin, 14 objective responses were confirmed in 72 patients (25%) with malignant pleural mesothelioma. Indeed, responses were seen in cisplatin-refractory patients. Based on the promising results from these combination trials, two large phase III studies have begun. The first study was a multicenter, multinational trial sponsored by Eli Lilly and Company, which randomized more than 430 patients with malignant pleural mesothelioma to cisplatin with or without pemetrexed. trial ever conducted in mesothelioma. The second trial is being conducted by the European Organization for the Research and Treatment of Cancer (EORTC) and compares cisplatin with or without raltitrexed with planned accrual of 240 patients. In both trials, survival is the main endpoint. These trials will help to define the role of these new antifolates in malignant pleural mesothelioma. Copyright 2002 by W.B. Saunders Company.
UI - 11836674
AU - Girling DJ; Muers MF; Qian W; Lobban D
TI - Multicenter randomized controlled trial of the management of unresectable malignant mesothelioma proposed by the British Thoracic Society and the British Medical Research Council.
SO - Semin Oncol 2002 Feb;29(1):97-101
AD - Medical Research Council, Clinical Trials Unit, Cancer Division, London, United Kingdom.
Malignant mesothelioma is almost invariably fatal. The incidence of the disease is rising rapidly in many countries, and there is no generally accepted standard treatment for patients with unresectable disease. According to current British Thoracic Society (BTS) guidelines, patients should be treated with active symptom control (ASC), involving (1) regular follow-up in a specialist clinic; (2) structured assessments of physical, psychological and social problems with appropriate action; (3) rapid involvement of additional specialists; and (4) parallel nursing support. Although many nonrandomized studies have reported tumor responses to anticancer chemotherapy, few have studied palliation and it is not known whether chemotherapy prolongs survival or provides clinically worthwhile palliation with acceptable toxicity when given in addition to ASC. We therefore plan to conduct a multicenter randomized controlled trial comparing (1) ASC alone, (2) ASC plus mitomycin vinblastine and cisplatin (MVP), and (3) ASC plus vinorelbine (N; Navelbine, Pierre Fabre Oncology, Winchester, UK). We chose these chemotherapy regimens because they have been shown in nonrandomized studies to provide good symptom control as recorded by patients. The outcome measures are overall survival, palliation of symptoms, performance status, analgesic usage, toxicity, quality of life, tumor response, and recurrence/progression-free survival. In a preliminary feasibility study, we are assessing the acceptability of the trial design to patients and the suitability of two standard quality-of-life instruments in mesothelioma. Data will help us to decide the final details of the large multicenter trial. Copyright 2002 by W.B. Saunders Company.
UI - 11857086
AU - Foddis R; De Rienzo A; Broccoli D; Bocchetta M; Stekala E; Rizzo P;
TI - Tosolini A; Grobelny JV; Jhanwar SC; Pass HI; Testa JR; Carbone M SV40 infection induces telomerase activity in human mesothelial cells.
SO - Oncogene 2002 Feb 21;21(9):1434-42
AD - Cancer Immunology Program, Department of Pathology, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, Illinois, IL 60153, USA.
Mesotheliomas are malignant tumors of the pleural and peritoneal membranes which are often associated with asbestos exposure and with Simian virus 40 (SV40) infection. Telomerase activity is repressed in somatic cells and tissues but is activated in immortal and malignant cells. We evaluated telomerase activity in seven primary malignant mesothelioma biopsies and matched lung specimens and 20 mesothelioma cell lines and eight corresponding primary tumor cultures. All the tumor biopsies, and nearly all primary cell mesothelioma cultures and cell lines were telomerase positive. The findings in cell lines paralleled those observed in primary cultures in cases where paired samples were available. Next, we found that SV40, a DNA tumor virus present in approximately 50% of mesothelioma biopsies in the USA, induced telomerase activity in primary human mesothelial cells, but not in primary fibroblasts. Telomerase activity became detectable as early as 72 h following wild-type (strain 776) SV40 infection, and a clear DNA ladder was detectable 1 week after infection. The amount of telomerase activity increased during passage in cell culture and appeared to parallel increases in the cellular amounts of the SV40 large T-antigen. Thus, SV40 infection leads to telomerase activity before the infected mesothelial cells become transformed and immortalized. SV40 infection of human fibroblasts did not cause detectable telomerase activity. We also determined that the SV40 small t-antigen (tag) plays an important role in inducing telomerase activity because this activity was undetectable or minimal in mesothelial cells infected and/or transformed by SV40 tag mutants. Asbestos alone did not induce telomerase activity, and asbestos did not influence telomerase activity in mesothelial cells infected with SV40. Induction of telomerase activity by SV40 may be related to the very high rate of mesothelial cell immortalization that is characteristically associated with SV40 infection of mesothelial cells.
UI - 11850833
AU - Klein G; Powers A; Croce C
TI - Association of SV40 with human tumors.
SO - Oncogene 2002 Feb 14;21(8):1141-9
AD - Microbiology and Tumor Biology Center, Karolinska Institut, S 171-77, Stockholm, Sweden.
In 1994, PCR and protein studies suggested that SV40 DNA sequences and proteins were present in 29/48 (60%) USA human mesothelioma samples. Sequence analysis confirmed that the sequences were homologous to SV40. One year later, SV40 was also found in 5/9 human mesotheliomas, and in 1996 SV40 was also reported to be present in 1/3 of the tumor specimens examined. These reports, in combination with an earlier study in 1992 which had detected SV40 in human brain tumors, raised concerns that SV40 was associated with certain types of human tumors, specifically mesothelioma, bone, and brain tumors. These findings raised concerns, because these tumor types are the same malignancies that had been observed in animals injected with SV40. However, a study in 1996 and a presentation made at the International Mesothelioma Interest Group, IMIG in 1997 failed to detect SV40 in mesotheliomas, suggesting the possibility that laboratory artifacts, such as PCR contamination, had caused the previous positive findings. In 1997, the FDA, the NIH, and the CDC organized an international conference in Bethesda to review the literature and to address the possibility that SV40 was present in, and was possibly the cause of, some human tumors. The results of that conference were reported the same year in a meeting review in Oncogene by Carbone and colleagues. Briefly, the consensus was that before accepting the possibility that SV40 was present in human tumors, a multi-laboratory study needed to be conducted. It was recommended that a blinded multi-laboratory study be directed by an independent scientist not previously associated with the controversial reports of SV40 in human specimens. It was also recommended that this study include laboratories that had reported positive findings as well as laboratories that had failed to detect SV40 in human specimens. Since 1997, about 30 independent reports have been published on this topic, including the multi-laboratory study. Evidence in favor and against a possible association of SV40 with human cancer was reviewed at an international entitled "Malignant Mesothelioma: Therapeutic Options and the Role of SV40, 2001". The main focus was the association of SV40 with mesothelioma and other human tumors. At the end of the meeting, a panel discussion, which included independent experts who had not published on this topic, critically reviewed the evidence presented at the meeting. The results of the meeting and of the final panel discussion are outlined below.
UI - 11869020
AU - Begossi G; Gonzalez-Moreno S; Ortega-Perez G; Fon LJ; Sugarbaker PH
TI - Cytoreduction and intraperitoneal chemotherapy for the management of peritoneal carcinomatosis, sarcomatosis and mesothelioma.
SO - Eur J Surg Oncol 2002 Feb;28(1):80-7
AD - The Washington Cancer Institute, Washington Hospital Center, Washington, DC 20005, USA.
Despite new developments in multi-modality treatments, complete resection remains as an absolute requirement for cure of gastrointestinal cancer. We have reported benefits from combined treatment with complete cytoreduction and intraperitoneal chemotherapy. This has been achieved with low morbidity and mortality. Success in the surgical management of peritoneal surface malignancy depends on the surgeon's ability to complete complex cytoreductive procedures so that only microscopic residual disease remains. This paper describes the current strategy that the surgical oncologist should pursue in the treatment of patients with peritoneal carcinomatosis, sarcomatosis and mesothelioma. Technical details required for this surgery include patient position, incision and exposure, complete lysis of adhesion, electroevaporative dissection with irrigation and suction to preserve the translucent quality of tissues, peritonectomy procedures, proper positioning of tubes and drains for intraperitoneal chemotherapy, and reconstructive surgery. Understanding the treatment and mastery of surgical skills to manage the peritoneal surface spread of cancer has led to long-term survival of selected patients. Combination of this treatment strategy with proper patient selection has reduced the mortality and morbidity. The success of cytoreductive surgery and perioperative intraperitoneal chemotherapy depends on a long-term dedication to achieve the full potential of a curative outcome. Our unit has continued to achieve good results over two decades as improved results of treatment have evolved. Copyright Harcourt Publishers Limited.
UI - 11333415
AU - Bailey WJ
TI - RE: Mesothelioma and lung tumors attributable to asbestos among petroleum workers. Am. J. Ind. Med. 2000. 37:275-282.
SO - Am J Ind Med 2001 May;39(5):513-4, 522-3; discussion 517-21
UI - 11333416
AU - Tsai SP; Waddell LC Jr; Ransdell JC
TI - RE: Mesothelioma and lung tumors attributable to asbestos among petroleum workers. Am. J. Ind. Med. 2000. 37:275-282.
SO - Am J Ind Med 2001 May;39(5):515-21; discussion 517-21
UI - 11717014
AU - Martin-Ucar AE; Edwards JG; Rengajaran A; Muller S; Waller DA
TI - Palliative surgical debulking in malignant mesothelioma. Predictors of survival and symptom control.
SO - Eur J Cardiothorac Surg 2001 Dec;20(6):1117-21
AD - Department of Thoracic Surgery, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK.
OBJECTIVE: Malignant mesothelioma (MM) typically presents at an advanced stage. In the UK surgical intervention has been mostly reserved for tissue diagnosis or chemical pleurodesis. However, the role of debulking surgery in symptom control has not been fully explored. METHODS: In a prospective cohort study, 51 consecutive patients presenting with MM underwent palliative surgical debulking for symptomatic relief (all patients presented with dyspnoea, 39 also had pain and two had a co-existing pleural empyema). Patients with early disease who underwent extrapleural pneumonectomy were excluded. The treatment aims were pleural drainage, lung re-expansion, pleurodesis and pleural debulking for symptom control. If the lung re-expanded after drainage of the effusion a subtotal parietal pleurectomy was performed via Video Assisted Thoracic Surgery (VATS). If the lung remained entrapped, a parietal and visceral decortication using VATS or thoracotomy was performed. The changes in subjective dyspnoea and pain scores were recorded at 6 weeks and 3, 6 and 12 months after surgery. Prognostic factors were analyzed to determine their influence on survival and symptom control. RESULTS: VATS pleurectomy was possible in 17 patients (34%), whilst decortication was required in the remainder (three by VATS and 31 by thoracotomy). Median postoperative stay was 7 days (range 2-17) with 30-day mortality of 7.8% (four of 51 patients). Morbidity included postoperative empyema in two patients (4%) and prolonged air-leak in five (9.8%). Overall significant symptomatic benefit was obtained up to 3 months after surgery but subsequently increasing mortality offset these benefits. Epithelial cell type and absence of weight loss prior to surgery were found to predict longer survival and successful symptom control. CONCLUSIONS: Debulking surgery has a beneficial role in symptom control for unresectable MM. However, this surgery should be reserved for those patients who present with epithelial cell type and before significant loss of weight.
UI - 10672054
AU - Delahunt B; Eble JN; King D; Bethwaite PB; Nacey JN; Thornton A
TI - Immunohistochemical evidence for mesothelial origin of paratesticular adenomatoid tumour.
SO - Histopathology 2000 Feb;36(2):109-15
AD - Departments of Pathology, Wellington School of Medicine, University of Otago, New Zealand. firstname.lastname@example.org
AIMS: To investigate the histogenesis of paratesticular adenomatoid tumour by use of immunohistochemical markers for a variety of carcinomas and mesothelioma. METHODS AND RESULTS: Immunohistochemical staining of sections from 12 cases of paratesticular adenomatoid tumour was undertaken using primary antibodies to antigens expressed by benign epithelial cells and carcinoma (cytokeratin AE1/AE3, cytokeratin 34ssE12, epithelial membrane antigen, MOC-31, Ber-EP4, CEA, B72.3, LEA.135, Leu M1), stromal and vascular markers (vimentin, CD34, factor VIII), and mesothelioma-associated antigens (thrombomodulin, HBME-1, OC 125) and p53 protein. There was absence of immunohistochemical expression of epithelial/carcinoma markers MOC-31, Ber-EP4, CEA, B72.3, LEA.135, Leu M1 and to factor VIII and CD34. All tumours expressed cytokeratin AE1/AE3, epithelial membrane antigen and vimentin, with weak expression of cytokeratin 34ssE12 in 25% of tumours. Each tumour showed expression of thrombomodulin, HBME-1 and OC 125 in a membranous distribution. p53 protein expression was not detected. CONCLUSIONS: The immunohistochemical profile of paratesticular adenomatoid tumour is strongly supportive of a mesothelial cell origin.
UI - 11813251
AU - De Rienzo A; Tor M; Sterman DH; Aksoy F; Albelda SM; Testa JR
TI - Detection of SV40 DNA sequences in malignant mesothelioma specimens from the United States, but not from Turkey.
SO - J Cell Biochem 2002;84(3):455-9
AD - Human Genetics Program, Fox Chase Cancer Center, 7701 Burholme Avenue, Philadelphia, PA 19111, USA.
The incidence of malignant mesothelioma (MM) shows a strong epidemiological association with exposure to asbestos fibers. Recently, simian virus 40 (SV40) DNA sequences have been reported in MM tumor specimens from the United States and several European countries, and the SV40 tumor virus has been implicated as a potential co-factor in the etiology of this disease. However, several large studies from the US, Finland, and Turkey did not detect SV40 sequences in MM samples. To address this discrepancy, MM specimens from Turkey and the US were analyzed in the same laboratory under identical conditions to detect the presence of SV40 DNA. We detected SV40 sequences in 4 of 11 specimens from the United States, but in none of the 9 Turkish samples examined. These findings suggest that geographical differences exist with regard to the involvement of SV40 in human tumors. Copyright 2001 Wiley-Liss, Inc.
UI - 11847028
AU - Bard M; Debrosse D; Caliandro R; Girard P; Grunenwald D; Ruffie P
TI - [Current insights in malignant pleural mesothelioma]
SO - Bull Cancer 2002 Jan;89(1):67-74
AD - Departement de medecine, Institut Gustave-Roussy, 39, rue Camille-Desmoulins, 94805 Villejuif Cedex.
Faced with the rising incidence of malignant pleural mesothelioma (MPM), the medical community is now busy to improve the care for this pathology. Although there is still no unanimously recognized therapy for MPM, long survival has been observed for some patients treated with associated therapies (surgery + radiotherapy + chemotherapy). However, the detection and the aggressive care of early stages MPM must be justified by a demonstrated survival improvement with conservation of a good quality of life. This article tries to summarize current insights concerning epidemiology, diagnosis and treatment of MPM. At now, more questions than responses exist concerning the care of this severe prognosis disease.
UI - 11834661
AU - de Bree E; van Ruth S; Baas P; Rutgers EJ; van Zandwijk N; Witkamp AJ;
TI - Zoetmulder FA Cytoreductive surgery and intraoperative hyperthermic intrathoracic chemotherapy in patients with malignant pleural mesothelioma or pleural metastases of thymoma.
SO - Chest 2002 Feb;121(2):480-7
AD - Department of Surgical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
STUDY OBJECTIVES: No established curative treatment is available for pleural thymoma metastases and malignant pleural mesothelioma (MPM). Recently, peritoneal malignancies have been treated by cytoreductive surgery and intraoperative hyperthermic intracavitary perfusion chemotherapy (HIPEC). We investigated the feasibility and safety of this multimodality treatment in the thoracic cavity. DESIGN: Patients with pleural thymoma metastases or early-stage MPM were enrolled in a feasibility study. Morbidity, recurrence, and survival rates were recorded. SETTING: The Netherlands Cancer Institute. PATIENTS: Three patients with pleural thymoma metastases and 11 patients with pleural mesothelioma were treated. INTERVENTIONS: Cytoreductive surgery and intraoperative hyperthermic intrathoracic perfusion chemotherapy (HITHOC) with cisplatin and adriamycin were performed. The mesothelioma patients received adjuvant radiotherapy on the thoracotomy wound and drainage tracts. MEASUREMENTS AND RESULTS: Morbidity and mortality rates were 47% and 0%, respectively. Reoperation was necessary in four cases. Severe chemotherapy-related complications were not observed. A solitary mediastinal and a contralateral pleural thymoma recurrence were successfully treated by radiotherapy and a contralateral HITHOC procedure. All thymoma patients were alive and free of disease after a mean follow-up period of 18 months. After a mean follow-up period of 7.4 months, nine mesothelioma patients are alive. Two mesothelioma patients died of contralateral pleural and peritoneal recurrent disease, while one patient is alive with locoregional recurrence. CONCLUSIONS: Cytoreductive surgery and HITHOC with cisplatin and adriamycin is feasible in patients with pleural thymoma metastases and early-stage MPM, and is associated with acceptable morbidity rates. Early data on locoregional disease control are encouraging, and a phase II study will be conducted.
UI - 11845101
AU - Desoubeaux N; Bouvier V; Gervais R; Galateau-Salle F; Thibon P; Leplumey
TI - T; Herbert C; Lecherbonnier Y; Daviet JP; Letourneux M [Malignant mesothelioma in Basse-Normandie, a French population study. Descriptive analysis, prognostic factors and survival]
SO - Rev Epidemiol Sante Publique 2001 Dec;49(6):523-9
AD - Federation des Registres de Basse-Normandie, Avenue Cote de Nacre, CHU Caen, 14032 Caen Cedex, France.
BACKGROUND: Malignant mesothelioma is a pleural and/or peritoneal tumor closely related to asbestos exposure, and its incidence should continue to increase during the first two decades of the 21(rst)century. The main prognostic factors described for this tumor are older age, sex, tumor stage and histological type. The aim of this study was to assess the incidence of pleural and peritoneal malignant mesothelioma in the County of Basse-Normandie (France), as well as their epidemiological characteristics, and the prognostic factors related to survival duration. METHODS: Cases were identified through repeated inquiries among all chest physicians and pathologists of the County of Basse-Normandie. A special care was taken in the validation of the diagnosis of each case. Incidence of mesothelioma was determined according to sex and age (5 years categories). Qualitative and quantitative variables were compared with the use of chi-square or Student's t tests respectively. Survival rate was calculated by Kaplan-Meier method, and prognostic factors were studied by means of Cox model. RESULTS: Study population consisted in all 80 malignant mesothelioma cases diagnosed in Basse-Normandie between the 1(rst) of pleural mesothelioma were 1.1/100 000 in men and 0.23/100 000 in women; annual incidence rates for peritoneal mesothelioma were 0.21/100 000 in men and 0.13/100 000 in women. Asbestos exposure was present in 63 cases (78.8%). The study of geographic distribution of mesothelioma cases revealed the influence of the main asbestos industrial settings, as well as the numerous scattered cases related to other occupational exposure. Mean survival duration was 9 months for pleural mesothelioma and 5 months for peritoneal mesothelioma. After adjustment on age, death risk was higher in asbestos-exposed than in non asbestos-exposed cases. CONCLUSION: This study confirms that malignant mesothelioma is closely related to asbestos exposure, but not only in main asbestos industrial settings. It suggests that asbestos exposure may take place among prognostic factors of this tumor.
The above citations and abstracts reflect those newly added to CANCERLIT for the month and topic listed in the title. The citations have been retrieved from CANCERLIT using a predefined search strategy of indexed subject terms. Although the search strategy has been refined as best as possible, citations may appear that are not directly related to the topic, and occasionally relevant references may be omitted.