[The clinical picture and therapy of malignant pleural mesothelioma].

BACKGROUND

In the general population malignant pleural mesothelioma is an uncommon tumor with an average annual incidence of 15 cases per million. Its biological behavior is characterized by an infiltrating and aggressive growth. Median survival ranges between 6 and 12 months. There are different therapeutic modalities (surgical treatment, radiotherapy, chemotherapy), which are used alone or in combination to influence the poor outcome of pleural mesothelioma.

PATIENTS AND METHODS

We report about 7 of our own cases, treated with surgery and radiotherapy (4) or with a combination of surgery, radiotherapy and chemotherapy (3) and discuss the clinical aspects, diagnosis and the different ways of treatment of malignant pleural mesothelioma and its influence on survival.

RESULTS AND CONCLUSION

The extrapleural pleuropneumonectomy should be reserved to patients with stage I disease. Radical operation here offers some prospect of long-term survival. Palliative surgery such as pleurectomy is the treatment of choice for extended disease. Radiotherapy using doses between 45 and 50 Gy is useful in a palliative setting. Anthracyclin or cisplatin based chemotherapy may be helpful in cases with disseminated disease. Prospective trials are necessary to further clarify the role of multimodality treatment programs for malignant pleural mesothelioma.