Diffuse malignant pleural mesothelioma

Extrapleural pneumonectomy for malignant pleural mesothelioma -- Argote-Greene et al. Pleuropneumonectomy in the management of diffuse malignant mesothelioma of the pleura in Ontario and Quebec: a retrospective study of 332 patients -- Ruffie et al. To whom correspondence should be addressed. Intrapleural or intraperitoneal administration of chemotherapeutic agents has been reported to produce transient reduction in the size of tumor masses and temporary control of effusions in small clinical studies. Palliative surgical resection in selected patients. Symptomatic treatment to include drainage of effusions, chest tube pleurodesis, or thoracoscopic pleurodesis. Vogelzang NJ: Malignant mesothelioma: diagnostic and management strategies for 1992. Markman M, Kelsen D: Efficacy of cisplatin-based intraperitoneal chemotherapy as treatment of malignant peritoneal mesothelioma.

Palliative surgery with or without postoperative radiation therapy B. Sessile polypoid lesions should be treated with surgical resection to ensure maximal potential for cure. Solitary mesotheliomas: Surgical resection en bloc including contiguous structures to ensure wide disease-free margins. Weissmann LB, Antman KH: Incidence, presentation and promising new treatments for malignant mesothelioma. Ball DL, Cruickshank DG: The treatment of malignant mesothelioma of the pleura: review of a 5-year experience, with special reference to radiotherapy. Bissett D, Macbeth FR, Cram I: The role of palliative radiotherapy in malignant mesothelioma.

Sugarbaker DJ, Mentzer SJ, DeCamp M, et al.: Extrapleural pneumonectomy in the setting of a multimodality approach to malignant mesothelioma. Rusch V, Saltz L, Venkatraman E, et al.: A phase II trial of pleurectomy/decortication followed by intrapleural and systemic chemotherapy for malignant pleural mesothelioma. Rusch VW, Piantadosi SP, Holmes EC: The role of extrapleural pneumonectomy in malignant pleural mesothelioma. The designations in PDQ that treatments are "standard" or "under clinical evaluation" are not to be used as a basis for reimbursement determinations.

Philadelphia: Lea however, failure rates are high secondary to the restrictive nature of the tumor. For the purposes of the discussion of treatment in this statement, the disease is categorized as either localized or advanced. See description of stage I above. Boutin C, Rey F: Thoracoscopy in pleural malignant mesothelioma: a prospective study of 188 consecutive patients - part 1: diagnosis. Histologic appearance appears to be of prognostic value, with most clinical studies showing that epithelial mesotheliomas have a better prognosis than fibrous or sarcomatous mesotheliomas. The special stains reported to be most useful include periodic acid-Schiff diastase, hyaluronic acid, mucicarmine, CEA, and Leu M1. Examination of the gross tumor at surgery and use of special stains or electron microscopy can often help.

Thoracoscopy can be valuable in obtaining adequate tissue specimens for diagnostic purposes. It can be especially difficult to differentiate mesothelioma from carcinoma on small tissue specimens. Attempts at diagnosis by cytology or needle biopsy of the pleura are often noncontributory. The epithelial form occasionally causes confusion with peripheral anaplastic lung carcinomas or metastatic carcinomas. Histologically, these tumors are composed of fibrous or epithelial elements or both. Sugarbaker DJ, Strauss GM, Lynch TJ, et al.: Node status has prognostic significance in the multimodality therapy of diffuse, malignant mesothelioma. Tammilehto L, Maasilta P, Kostiainen S, et al.: Diagnosis and prognostic factors in malignant pleural mesothelioma: a retrospective analysis of sixty-five patients.