[Diagnosis and treatment of pleural mesothelioma: a report of 40 cases].

Forty patients with pleural mesothelioma confirmed pathologically including 2 benign and 38 malignant lesions are reported. In the 38 malignant mesotheliomas, 12 were histopathologically defined while the rest were unclassified. In this series, 33 surgical resections and 3 thoracotomy biopsies were carried out, whereas 4 patients were not operated. In 36 thoracotomies, there was one death with an operative mortality of 2.8% (1/36). Of 33 surgical resections, 10 (31%) received combined therapy. Of the 3 thoracotomy biopsy cases, postoperative irradiation was given to one, irradiation plus chemotherapy to the second and no treatment to the third. In 4 who were not operated, one died without treatment, two accepted chemotherapy and the fourth was treated with irradiation plus chemotherapy. Only two (5%) of these 40 patients had history of exposure to asbestos. The pre- and intra-operative diagnostic conformity rate was 50%. Ten patients were lost from follow-up. The longest survival was twelve years and one month. The authors sum-up their 31-year (1963-1994) experience of this disease and discuss the occupational factors in etiology, clinical diagnosis, treatment options and the significance of pathological types on prognosis of pleural mesothelioma.