Malignant pleural mesothelioma

Abstract

The incidence of malignant pleural mesothelioma (MPM) has risen for some decades and is expected to peak between 2010 and 2020. Up to now, no single treatment has been proven to be effective and death usually occurs within about 12-17 months after diagnosis. Perhaps because of this poor prognosis, early screening has incited little interest. However, certain forms may have a better prognosis when diagnosed early and treated by multimodal therapy or intrapleural immunotherapy. Diagnosis depends foremost on histological analysis of samples obtained by thoracoscopy. This procedure allows the best staging of the pleural cavity with an attempt to detect visceral pleural involvement, which is one of the most important prognostic factors. Although radiotherapy seems necessary and is efficient in preventing the malignant seeding after diagnostic procedures in patients, there has been no randomized phase III study showing the superiority of any treatment compared with another. However, for the early-stage disease (stage I) a logical therapeutic approach seems to be neoadjuvant intrapleural treatment using cytokines. For more advanced disease (stages II and III) resectability should be discussed with the thoracic surgeons and a multimodal treatment combining surgery, radiotherapy and chemotherapy should be proposed for a randomized controlled study. Palliative treatment is indicated for stage IV. In any case, each patient should be enrolled in a clinical trial.

Osteopontin-mediated enhanced hyaluronan binding induces multidrug resistance in mesothelioma cells

“…A surgical resection is possible in only a minority of patients, and fewer than 15% of these patients live beyond 5 years (Sugarbaker et al, 1996;Boutin et al, 1998;Rusch and Venkatraman, 1999). For those who are not treated with a curative resection, the median survival has been reported to be 6 months (Ruffie, 1991;De Pangher Manzini et al, 1993).…”

Cytokine-armed vaccinia virus infects the mesothelioma tumor microenvironment to overcome immune tolerance and mediate tumor resolution

“…32 Thus, in this study we compared VV and FPV viral vectors, both of which express the same marker antigen (hemagglutinin, HA). [24][25][26][27] As both IL-2 and IL-12 have been shown to induce anti-tumor immunity against mesothelioma, [33][34][35][36][37] we compared VV with FPV vectors that encode either IL-2 or IL-12. We show here that i.t.…”

Mesotelioma maligno: descripción clínica y radiológica de 45 casos con y sin exposición a asbestos

“…1,2 La primera descripción histológica de éste fue realizada por E. Wagner en 1870, y no fue sino hasta 1960 cuando J.C. Wagner y colaboradores establecieron una vinculación entre el mesotelioma maligno y la exposición a asbestos; así, describieron una enfermedad con un largo periodo de latencia, que afectaba fundamentalmente a mineros y trabajadores de molinos expuestos a crocidolita. [3][4][5] La incidencia del MM en el ámbito mundial es variable. En Estados Unidos de América (EUA) se han notificado 2 200 nuevos casos por año, con un incremento aproximado de 50% en la última década.…”

“…Se calcula que el riesgo de desarrollar enfermedad pleural secundaria a dicha exposición es de 8% -13%. 1,3,4 La radiación también parece tener un papel importante en el desarrollo del MM. 13 Así, en pacientes con diagnóstico de seminoma, cáncer de cérvix y linfoma de Hodgkin, tratados con radioterapia, se ha observado un aumento en la incidencia de MM.…”

“…[15][16][17] Histológicamente, el MM se divide en tres grupos: epitelial, sarcomatoide y mixto. 1,3,4 El tipo sarcomatoide se asocia con grandes masas tumorales, ausencia o mínimo derrame pleural y mayor frecuencia de metástasis hematógenas. El tipo epitelial constituye aproximadamente 60% del total, y se subdivide en tubulopapilar, glandular y sólido.…”