Localized Mesothelioma Of The Pleura: Benign And Malignant Variants

Our plain-English summary of Localized Mesothelioma Of The Pleura: Benign And Malignant Variants, by N. Okike, P.E. Bernatz, L.B. Woolner (1978).

The study

• Authors: N. Okike, P.E. Bernatz, L.B. Woolner
• Published: Journal Of Thoracic And Cardiovascular Surgery 75(3):363-372, March (1978)
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library, J-M no. 001077. The article is still under copyright, so we describe it here rather than post it.

In plain English

This study reviewed patients treated at the Mayo Clinic in Rochester, Minnesota, for localized mesothelioma of the pleura. From 1950 through December 1974, 60 patients (23 men and 37 women, aged 23 to 83) were treated, and their tumor specimens were studied. Based on how the tissue looked under the microscope, the authors classified 52 tumors as benign and 8 as malignant. Follow-up was available for all 60. In the 52 benign cases, follow-up ranged from 1 to 24 years. Forty-eight (92 percent) survived 5 years, the four earlier deaths were not related to the tumor, and two patients had recurrence. Eight of 10 benign patients with joint and bone changes and finger clubbing had complete relief after surgery. Among the 8 malignant cases, one patient died soon after surgery, and every patient who survived the first 6 months had recurrence or spread. One malignant-variant patient had significant asbestos exposure 20 years earlier. Asbestos bodies were not found in the tumors. The authors concluded that more aggressive local resection is indicated for the malignant variant.

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: Retrospective review (case series) of treated patients at one institution
• Who was studied: 60 patients (23 men, 37 women, aged 23 to 83 years, mean 53) treated for localized pleural mesothelioma at the Mayo Clinic, Rochester, Minnesota, from 1950 until December 1974. The methods describe surgical resection in all 60, but the treatment section reports that one malignant-variant patient had an open biopsy followed by irradiation. A further 24 patients treated before 1950 were excluded because their cases had been published before.
• Exposure: Asbestos exposure was not the subject of the study. One patient with the malignant variant had significant asbestos exposure 20 years before the tumor was found. No fiber type is given.
• Main results:
  • Judged by histology, 52 patients had the benign variant and 8 had the malignant variant.
  • Benign variant: follow-up ranged from 1 year to 24 years.
  • Benign variant: 48 of 52 patients (92 percent) survived 5 years.
  • Benign variant: the four deaths within 5 years of operation were not related to the localized mesothelioma.
  • Benign variant: after 10 years of follow-up, the survival curve was identical to that of the general population.
  • Benign variant: two patients, both of whom first had their tumor removed elsewhere, had recurrent disease. One recurred 17 years after partial lobectomy. The other recurred 5 years after excision and became malignant, although still localized.
  • Benign variant: 8 of the 10 patients with hypertrophic pulmonary osteoarthropathy and digital clubbing had complete relief of these symptoms after the operation.
  • The joint manifestations seen with the benign variant could not be documented in any patient with the malignant variant.
  • Malignant variant: one patient died in the postoperative period, after pneumonectomy.
  • Malignant variant: all patients who survived the first 6 months after their initial operation had recurrence or distant metastasis.
  • Malignant variant: of the 7 patients who survived the operation, one died within 1 year and five died within 2 years. The longest survivor lived 9 years before dying from malignant mesothelioma.
  • Asbestos bodies were not identified in these tumors.
• The authors' conclusion: The authors concluded that more aggressive local resection is indicated for the malignant variant. They also wrote that recurrence should encourage more extensive resection of localized pleural mesothelioma in general.

Topics

Medical terms in this study, explained in our Lexicon: Localized Malignant Mesothelioma, Pleura, Clubbing, Asbestos Exposure, Asbestos Bodies.

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