Malignant pleural mesothelioma is a severe cancer mainly caused by asbestos exposure. It often appears decades after exposure. Early on, symptoms can be unclear, making it difficult to diagnose. Even though the cancer is rare, a mesothelioma diagnosis is still concerning since there is a lack of treatment options. An article looked at 70 mesothelioma cases at Getafe University Hospital in Spain from 2008 to 2021.
The study aimed to detail different aspects of malignant pleural mesothelioma. The different parts that were covered included clinical, histological, radiological, and treatment features. The hospital’s Ethics and Research Committee approved it. The sample included 70 patients, mostly elderly males with an average age of 71. Asbestos exposure was found in 61 percent of cases. Common symptoms patients experienced included shortness of breath (59 percent), chest pain (53 percent), cough (37 percent), and weight loss (23 percent). Common diagnostic methods include thoracoscopy (59 percent), image-guided pleural biopsy (21 percent), thoracotomy (17 percent), and thoracentesis (four percent). Staging of the cases showed that 50 percent were in stage I, nine percent were in Stage II, 16 percent were in stage III, and 25 percent were in stage IV. Histological analysis revealed that 73 percent of patients had the epithelioid subtype, 14 percent were biphasic, and 13 percent were sarcomatoid. Treatments included chemotherapy with carboplatin and pemetrexed (73 percent), palliative care (16 percent), and surgery with pleurectomy and decortication (11 percent). Pleurodesis was done in 30 percent of patients.
The median survival of the study’s participants was 10 months. Different outcomes came from different treatments. Surgery resulted in 17 months of survival, chemotherapy resulted in 10 months of survival, and palliative care led to three months of survival. Patients with the epithelioid subtype had better outcomes compared to sarcomatoid and biphasic subtypes. Multimodal therapy combines surgery, chemotherapy, and radiation. This improves outcomes. It is also recommended to receive extended pleurectomy decortication surgery (EPD) and hyperthermic intrathoracic chemotherapy (HITHOC). EPD removes the diseased pleura and other tissue while HITHOC is applied to the chest to kill remaining cancer cells.
The study found a high rate of malignant pleural mesothelioma in Getafe, Spain. This is due to past exposures in local industries. Common symptoms were breathing difficulty and chest pain, but these symptoms are not specific to pleural mesothelioma. Diagnosing the illness was best done through thoracoscopy and CT-guided biopsy. The epithelioid type had a better outlook, especially if fully removed. Advanced stages of the disease and the sarcomatoid subtype led to worse outcomes. There were limitations to the study. It only focused on one cancer center. It also used retrospective data, which could introduce biases. Clinical recommendations also changed over time, affecting the study’s findings. This restricts how widely the results can be applied.
The study showed how asbestos exposure rates raise pleural mesothelioma rates. It stresses early detection and thorough treatment. Multimodal therapy including surgery, chemotherapy, and radiation boost survival odds, especially for early-stage patients. More research and joint registries are crucial for managing the disease. Understanding the progression of pleural mesothelioma and its treatment options helps patients and caregivers make better informed decisions, allowing better outcomes and improved quality of life for those struggling with the disease.
