Malignant mesothelioma

Kao, Steven; Reid, Glen; Lee, K.; Vardy, Janette; Clarke, Stephen; Zandwijk, Nico van

doi:10.1111/j.1445-5994.2010.02223.x

Cited by 30 publications

(26 citation statements)

References 66 publications

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“…Once the diagnosis is confirmed by histology, multi-disciplinary management produces the best outcome [7]. The prognosis for patients with MPM is poor, with a survival time of approximately two years from diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Malignant peritoneal mesothelioma presenting as recurrent adhesion obstruction in general surgery: a case report

Naraynsingh¹,

Ramdass²,

Lum³

2011

J Med Case Reports

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IntroductionMalignant peritoneal mesothelioma is a well-described entity in many reports in the literature in which it has been associated with asbestosis. However, there is no information describing the gross appearance and cardinal features seen during laparotomy, hence it is easy for the unwary surgeon to miss the diagnosis of this rare condition.Case presentationA 49-year-old man of African descent presented to our hospital with a three-month history of weight loss, anorexia, abdominal distension, and general signs of cachexia and ascites on second presentation. At first presentation one year prior to this, he had undergone a laparotomy at our institution by a different team for intestinal obstruction secondary to adhesions with no biopsy taken. The patient's condition subsequently progressively deteriorated, and investigations including upper and lower gastrointestinal endoscopies and computed tomography of the abdomen were inconclusive, except for some free fluid in the peritoneal cavity and diffuse, mild thickening of the gut wall and mesentery. A second-look exploratory laparotomy revealed widespread nodular thickening of the visceral peritoneum with a striking, uniformly diffuse, erythematous, and velvety appearance. The peritoneal biopsy histology showed that the patient had malignant peritoneal mesothelioma. His condition deteriorated rapidly, and he died eight weeks after surgery.ConclusionOur report aims to increase the diagnosing clinician's awareness of the cardinal features of malignant peritoneal mesothelioma and thus reduce diagnostic errors and delays in treatment.

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Section: Discussionmentioning

confidence: 99%

Malignant peritoneal mesothelioma presenting as recurrent adhesion obstruction in general surgery: a case report

Naraynsingh¹,

Ramdass²,

Lum³

2011

J Med Case Reports

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“…Malignant mesothelioma (MM) is an aggressive, asbestos-related neoplasm that arises from the mesothelium, a membrane lining the serosal cavities (1). Previously rare, MM is increasing in incidence in developed countries (2), but because of the continued widespread use of asbestos in developing countries (3), MM will remain a worldwide health issue in the ensuing decades.…”

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confidence: 99%

High Blood Neutrophil-to-Lymphocyte Ratio Is an Indicator of Poor Prognosis in Malignant Mesothelioma Patients Undergoing Systemic Therapy

Kao

Pavlakis

Harvie

et al. 2010

Clinical Cancer Research

282

239

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Purpose: Asbestos-induced chronic inflammation is implicated in the pathogenesis of malignant mesothelioma (MM). We have investigated blood neutrophil-to-lymphocyte ratio (NLR), an index of systemic inflammation, as a prognostic factor in MM patients.Experimental Design: Patients with MM who had systemic therapy at participating institutes were studied. Potential prognostic factors such as age, gender, performance status, histologic subtype, and baseline laboratory parameters, including NLR, were analyzed. Overall survival from commencement of therapy was determined by the Kaplan-Meier method. Multivariate analyses using Cox Regression model were performed with significant factors (P 0.05) to determine their independent effect.Results: A total of 173 MM patients undergoing systemic therapy including 119 patients receiving firstline therapy and 54 patients receiving second-or third-line therapy were included in this retrospective evaluation. Forty-two percent of patients had an elevated NLR at baseline. The following variables were predictive of survival: female gender (P ¼ 0.044), epithelioid histologic subtype (P < 0.001), baseline white blood cell count less than 8.3 Â 10 9 /L (P ¼ 0.008), baseline platelet count 400 Â 10 9 /L or less (P ¼ 0.05), and NLR of 5 or less (P < 0.001). After multivariate analysis, histologic epithelioid subtype [hazard ratio (HR) ¼ 2.0; 95% confidence interval (CI) ¼ 1.3-2.9; P ¼ 0.001], and NLR less than 5 (HR ¼ 2.7; 95% CI ¼ 1.8-3.9; P < 0.001) remained independent predictors. The 1-year survival rate was 60% versus 26%, whereas the 2-year survival rate was 34% versus 10% for NLR less than 5 and 5 or greater, respectively. In the separate analyses of chemotherapy-naive and previously treated patient groups, NLR was an independent predictor of survival in both groups.Conclusion: Our results indicate that NLR is an independent predictor of survival for patients with MM undergoing systemic therapy. Clin Cancer Res; 16(23); 5805-13. Ó2010 AACR.

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“…How long is long enough in follow‐up? It is true that very delayed instances of appearance of malignancy years after benign pleura biopsies have been reported, particularly given the prolonged time to development of malignancies such as mesothelioma of between 20 and 40 years from asbestos exposure . However, such instances are very uncommon and the 2‐year follow‐up reported here is clinically very reasonable.…”

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confidence: 59%