Larsson S, Philipson B M, Dernevik L, Zettergren L
Department of Thoracic Surgery, Sahlgren's Hospital, University of Gothenburg, Sweden.
Scand J Thorac Cardiovasc Surg. 1988;22(1):65-72. doi: 10.3109/14017438809106054.
A surgical series of 23 patients with pleural mesothelioma is reviewed. Three who had benign localized mesothelioma of fibrous type are alive and well at least 10 years postoperatively. In two others, radically extirpated localized mesothelioma was histologically classified as benign, but later proved to be malignant, causing death from recurrent disease 27 and 79 months postoperatively. Four patients with diffuse malignant mesothelioma underwent pleurectomy or open biopsy and survived for 2-9 months. Radical en-bloc pleuropneumonectomy was performed on 14 patients with diffuse malignant mesothelioma. One patient died postoperatively and the others succumbed to the disease after 3-51 (mean 20) months. The survival time was greater than or equal to 1 year in 62% of the patients and greater than 3 years in 23%. Patient age, histologic tumour type and extent of disease seemed to be important prognostic factors. Despite the generally poor prognosis, the results of radical surgery in this study appear to warrant an aggressive approach to treatment of benign or localized malignant pleural mesothelioma, and possibly also to stage I diffuse malignant mesothelioma of epithelial type.
回顾了一组23例胸膜间皮瘤患者的外科手术病例。3例患有纤维型良性局限性间皮瘤的患者术后至少存活了10年，情况良好。另外2例患者，经根治性切除的局限性间皮瘤在组织学上被分类为良性，但后来被证明是恶性的，分别在术后27个月和79个月因疾病复发而死亡。4例弥漫性恶性间皮瘤患者接受了胸膜切除术或开放性活检，存活了2至9个月。对14例弥漫性恶性间皮瘤患者进行了根治性整块胸膜肺切除术。1例患者术后死亡，其他患者在3至51个月（平均20个月）后死于该疾病。62%的患者生存时间大于或等于1年，23%的患者生存时间大于3年。患者年龄、组织学肿瘤类型和疾病范围似乎是重要的预后因素。尽管总体预后较差，但本研究中根治性手术的结果似乎值得对良性或局限性恶性胸膜间皮瘤，以及可能对I期上皮型弥漫性恶性间皮瘤采取积极的治疗方法。
