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Vol.49 No.7 contents | Japanese/English |
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- Original Article -
Malignant Pleural Mesothelioma -A Clinical Study of 81 Patients from Okayama Rosai Hospital-
Hideyuki Nishi1, Kazuhiro Washio1, Nobukazu Fujimoto1, Kenichi Gemba1, Takumi Kishimoto1, Nobuyoshi Shimizu11Main Center for Asbestos-related Disease for Diagnosis and Treatment, Okayama Rosai Hospital, Japan
Objective. We examined the clinical features and prognosis of malignant pleural mesothelioma. Subjects. From 1993 to 2008, 81 patients from the Main Center for Asbestos-related Disease for Diagnosis and Treatment, Okayama Rosai Hospital, were enrolled. Results. Of the 81 patients, 74 were men and 7 were women with an average age of 66.0 years old. A past history of exposure to asbestos was confirmed in 71 patients (87.7%). Seventy-one patients (87.7%) presented with symptoms. A definitive diagnosis was obtained by pleural biopsy in 55 patients (67.9%) within 4.5 months (median) from the first visit. Chemotherapy and/or radiotherapy were performed in 40 patients. Operation was performed in 24 patients. Best supportive care alone was carried out in 17 patients. The median survival of all patients was 10.8 months. The overall 5-year survival rate was 5.0%. The overall 1- and 3-year survival rates after operation were 65.1% and 23.2% respectively, while the median survival was 13.2 months. With chemotherapy only, the overall 1- and 3-year survival rates were 39.2% and 0% respectively, while the median survival was 10.8 months. There were significant differences in survival rates between the resection and chemotherapy only groups (p=0.04). In a multivariable analysis by the Cox proportional hazards model with controls for performance status, clinical stage, operation, chemotherapy and N factor, non-resected patients had a higher hazard ratio (1.622) than resected patients. Conclusion. Extrapleural pneumonectomy is a prognostic factor in malignant pleural mesothelioma. The establishments of diagnosis at an early stage, the development of adjuvant therapy and more effective chemotherapy are required for the improvement of survival in patients with malignant pleural mesothelioma.
key words: Malignant pleural mesothelioma, Extrapleural pneumonectomy, Prognosis
Received: January 6, 2009
Accepted: June 8, 2009
JJLC 49 (7): 999-1005, 2009
