Uramoto Hidetaka, Takiguchi Tomoya, Koizumi Tomonobu, Tanimoto Azusa, Hayashi Ryuji, Nakazawa Yozo, Ito Ken-Ichi, Nakada Mitsutoshi, Hirono Yasuo, Nishino Yoshikazu, Yano Seiji
Department of Thoracic Surgery, Kanazawa Medical University, Kahoku, Japan.
Department of Epidemiology and Public Health, Kanazawa Medical University, Kahoku, Japan.
J Cancer Res Clin Oncol. 2022 May;148(5):1153-1158. doi: 10.1007/s00432-021-03699-z. Epub 2021 Jun 29.
Malignant pleural mesothelioma (MPM) is a major occupational and environmental neoplasm. The purpose of this study was to validate the clinical and epidemiological factors, diagnosis, and initial treatment among MPM patients in the Hokushin region.
We surveyed retrospective data from 152,921 cancer patients in 22 principal hospitals.
A total of 166 MPM cases were newly diagnosed. These patients consisted of 136 men and 30 women, with a median age of 69 years. We estimated the incidence rate for MPM to be 0.55 cases per 100,000 person-years in this study. The ratio per 100,000 population-years was 0.39 in Fukui, 0.60 in Ishikawa, 1.02 in Toyama and 0.35 in Nagano. Forty-five patients were discovered when diagnosed incidentally in patients under observations for other diseases. Forty-six cases were diagnosed as localized disease, while 13 had accompanying regional lymph node metastasis. Furthermore, 44 cases showed infiltration into adjacent organs. A histo-cytological diagnosis was made in 164 cases (98.8%). A surgical approach, chemotherapy, and radiotherapy were performed for 33, 88, and 6 patients, respectively, while 44 patients (26.5%) received best supportive care. Multimodality therapy was conducted in just 3.0% of the MPM patients CONCLUSION: MPM has a tragically rapid progression if discovered under observations for other diseases. Workers in health-related fields should be on high alert for aggressive MPM. Better evaluation and multi-disciplinary approaches to MPM in these regions are needed to optimize multimodality therapy.
恶性胸膜间皮瘤（MPM）是一种主要的职业性和环境性肿瘤。本研究的目的是验证北信地区MPM患者的临床和流行病学因素、诊断及初始治疗情况。
我们调查了22家主要医院152,921例癌症患者的回顾性数据。
共新诊断出166例MPM病例。这些患者包括136名男性和30名女性，中位年龄为69岁。在本研究中，我们估计MPM的发病率为每10万人年0.55例。每10万人口年的发病率在福井为0.39，在石川为0.60，在富山为1.02，在长野为0.35。45例患者是在因其他疾病接受观察时偶然被诊断出的。46例被诊断为局限性疾病，13例伴有区域淋巴结转移。此外，44例显示侵犯相邻器官。164例（98.8%）进行了组织细胞学诊断。分别对33例、88例和6例患者进行了手术、化疗和放疗，44例患者（26.5%）接受了最佳支持治疗。仅3.0%的MPM患者接受了多模式治疗。结论：如果在因其他疾病接受观察时发现MPM，其进展会非常迅速，令人痛心。从事健康相关领域的工作人员应高度警惕侵袭性MPM。需要对这些地区的MPM进行更好的评估和多学科治疗方法，以优化多模式治疗。
