Bagheri Reza, Haghi Seyed Ziaollah, Rahim Mohammad Bagher, Attaran Davoud, Toosi Mehdi Silanian
Lung Diseases and Tuberculosis Research Center, Mashhad University of Medical Science, Iran.
Ann Thorac Cardiovasc Surg. 2011;17(2):130-6. doi: 10.5761/atcs.oa.09.01427.
Pleural malignant mesothelioma is an uncommon but extremely invasive tumor which originates from mesothelial cells and usually occurs after prolonged exposure to asbestos. Different types of surgical and oncological therapeutic methods have been used resulting in various outcomes. The aim of this study was to evaluate, clinicopathologically, 40 patients with pleural malignant mesothelioma and the main factors influencing their prognosis.
In this study, 40 patients with a definitive diagnosis, who had been followed up for at least 3 years were studied according to these: epidemiologic factors, stage and pathological types, treatment method and complications, and by using factors that influence patients survival, we evaluated them statistically.
The M/F ratio was l3/1 with an average age of 55 years. Chest pain was the most common symptom. In 55% of patients, the lesions were localized in the left site and most were in Buchart stage I or II. The epithelial form was the most common pathological pattern (62.5%). 47.5% of patients only received radiotherapy and chemotherapy. Of patients who underwent decortication and pleurectomy with adjuvant therapy, extrapleural was performed in 20% of patients, and pneumonectomy, in 17.5%; and 15% refused any type of treatment. One patient died from the surgery. The most common surgical complication was wound infection. The average survival was 10.5 months, and the main factors influencing the survival were physiologic status, pathological form of disease, stage of disease and the pattern of pleural involvement.
Because of the low survival after multimodality invasive treatments in mesothelioma, aggressive therapeutic methods were recommended in patients with good physiological status and early clinical stage with a good pathology type.
胸膜恶性间皮瘤是一种罕见但极具侵袭性的肿瘤，起源于间皮细胞，通常在长期接触石棉后发生。已采用不同类型的外科和肿瘤治疗方法，产生了各种结果。本研究的目的是对40例胸膜恶性间皮瘤患者进行临床病理评估，并分析影响其预后的主要因素。
在本研究中，对40例确诊且至少随访3年的患者进行了如下研究：流行病学因素、分期和病理类型、治疗方法及并发症，并使用影响患者生存的因素进行统计学评估。
男女比例为13:1，平均年龄55岁。胸痛是最常见的症状。55%的患者病变位于左侧，多数处于布查特I期或II期。上皮型是最常见的病理类型（62.5%）。47.5%的患者仅接受放疗和化疗。在接受剥脱术和胸膜切除术并辅助治疗的患者中，20%的患者进行了胸膜外全肺切除术，17.5%的患者进行了肺切除术；15%的患者拒绝任何类型的治疗。1例患者死于手术。最常见的手术并发症是伤口感染。平均生存期为10.5个月，影响生存 的主要因素是生理状态、疾病的病理类型、疾病分期和胸膜受累模式。
由于间皮瘤多模式侵袭性治疗后的生存率较低，建议对生理状态良好、临床分期早且病理类型良好的患者采用积极的治疗方法。
