Clinical Presentation And Natural History Of Benign And Malignant Mesothelioma

Our plain-English summary of Clinical Presentation And Natural History Of Benign And Malignant Mesothelioma, by K.H. Antman (1981).

The study

• Author: K.H. Antman
• Published: Seminars In Oncology 8(3):313-320, September (1981)
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library, J-M no. 000716. The article is still under copyright, so we describe it here rather than post it.

In plain English

This 1981 article reviewed published reports on the clinical features and course of benign and malignant mesothelioma. It also described an earlier retrospective study of 40 patients at the Sidney Farber Cancer Center. The author reported that about two-thirds of benign mesotheliomas occurred in women. Asbestos exposure appeared not to be associated with benign mesothelioma, though occasional exposed patients had been reported. Among 873 patients with malignant mesothelioma compiled from multiple series, the men-to-women ratio was 2.8:1. Among 451 patients, 203 had the epithelial subtype, 117 the sarcomatous and 131 the mixed. The share of patients exposed to asbestos varied considerably between series. The author described a strong suggestion that patients with heavy or long exposure were significantly more likely to present with a peritoneal primary, a tumor starting in the peritoneum. Median survival ranged from 2 to 12 months after diagnosis. In the 40-patient study, stage I disease, symptoms for more than 6 months before diagnosis, and female sex were linked with significantly longer survival. No prognostic significance was observed for a history of asbestos exposure or smoking.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Review of published case series and literature on the clinical presentation and natural history of benign and malignant mesothelioma. It also describes an earlier retrospective study of 40 patients at the Sidney Farber Cancer Center.
• Who was studied: Patients with benign or malignant mesothelioma (pleural, peritoneal, pericardial and other sites) reported in published series. The compilations included 873 patients for sex ratio and 451 for histologic subtype. The article also cites an earlier retrospective study of 40 patients at the Sidney Farber Cancer Center.
• Exposure: Asbestos exposure in general, with no fiber types named. Settings included shipbuilding, the mines and mills of South Africa and Canada, textile mills, and household exposure from dust on work clothes. The review reported that the percentage of exposed patients varied considerably between series.
• Main results:
  • About two-thirds of benign mesotheliomas occurred in women.
  • There appeared to be no association between asbestos exposure and benign mesothelioma, although occasional patients with asbestos exposure and benign mesothelioma had been reported.
  • Among 873 patients with malignant mesothelioma compiled from multiple series, the ratio of men to women was 2.8:1.
  • Of 451 patients reported in a number of series, 203 had the epithelial (tubulopapillary) subtype, 117 the sarcomatous (fibrous) subtype and 131 a mixed subtype.
  • The review described a strong suggestion that patients reporting heavy or long-duration asbestos exposure were significantly more likely to present with a peritoneal primary.
  • Fibrosis and pleural plaques signifying asbestosis occurred in approximately a quarter of patients with pleural mesothelioma, and were found more frequently in patients with peritoneal disease.
  • Median survival of patients with malignant mesothelioma ranged between 2 and 12 months after diagnosis, with a total duration from the onset of symptoms of about 1 year.
  • For pericardial mesothelioma, median survival from diagnosis was less than 6 months.
  • In the earlier retrospective study of 40 patients at the Sidney Farber Cancer Center, patients with stage I disease, those with symptoms for more than 6 months before diagnosis, and women all survived significantly longer (p less than 0.05).
  • In the same study, patients presenting with shortness of breath lived about twice as long as patients first complaining of pain, but this difference was not statistically significant.
  • Longer survival had been associated with the epithelial subtype in many series, but none of these results were statistically significant.
  • No prognostic significance had been observed for a history of asbestos exposure or smoking.
• The authors' conclusion: The author stated that mesothelioma should be suspected in any middle-aged patient with pain or shortness of breath who is found to have a persistent pleural effusion.

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Asbestos Exposure, Peritoneum, Median Overall Survival.

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