Malignant mesothelioma

Our plain-English summary of Malignant mesothelioma, by P. Ruffié, M. Lehmann, F. Galateau-Sallé, et al (British Journal of Cancer, 2001).

The study

• Authors: P. Ruffié, M. Lehmann, F. Galateau-Sallé, J.L. Lagrange, J.C. Pairon, French National Federation of Cancer (FNCLCC)
• Journal: British Journal of Cancer
• Published: 2001;84 Suppl 2(Suppl 2):49-50
• Type of article: Guideline
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

In plain English

This article was not a research study. It was a clinical practice guideline on malignant mesothelioma from the French National Federation of Cancer (FNCLCC), reviewed in May 1999. It stated that in industrialized countries mesothelioma is a tumour associated with asbestos. For diagnosis, it said occupational asbestos exposure must be identified with a standardized questionnaire. Where the exposure history is unclear, counting asbestos bodies can help. A lung asbestos burden above that of the general population was defined as more than one asbestos body per sputum sample, more than one per millilitre of bronchoalveolar lavage, or more than 1000 per gram of dry lung tissue. Smaller numbers do not exclude past exposure. Diagnosing pleural mesothelioma required at least 10 biopsy samples, each 4 mm or larger, from multiple sites including apparently healthy areas, taken at thoracoscopy. The authors stated there was no standard treatment. Outcome depended more on prognostic factors than on the treatment chosen. Chest drain tracts and puncture sites must be irradiated routinely as prevention. Radical surgery, chemotherapy and immunotherapy were reserved for clinical trials.

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: clinical practice guideline (FNCLCC recommendations), not an original study
• Who was studied: No study population. The guideline concerns patients with malignant mesothelioma, mainly of the pleura, in France
• Exposure: Asbestos in general (no fiber types named), assessed through occupational history, pleural plaques on CT scan and asbestos body counts
• Main results:
  • Occupational asbestos exposure must be identified with a standardized questionnaire (a 'standard' recommendation)
  • Thresholds for a lung asbestos burden greater than that of the general population: more than one asbestos body per sputum sample, more than one per millilitre of bronchoalveolar lavage, more than 1000 per gram of dry lung tissue
  • Finding fewer asbestos bodies than these thresholds does not rule out previous asbestos exposure
  • Diagnosis of pleural mesothelioma requires at least 10 biopsy samples from multiple sites, each 4 mm or larger, including apparently healthy zones, taken at thoracoscopy
  • Three favourable prognostic factors were listed: stage I or II disease, epithelial histology, and patient performance status 0 or 1
  • There is no standard treatment, and outcome depends more on the patient's prognostic factors than on the treatment chosen
  • Chest drain tracts and puncture sites must be irradiated routinely and prophylactically (as prevention), a 'standard' recommendation
  • Radical surgery alone has not been validated and should be done only within a therapeutic study. Chemotherapy, immunotherapy and combined approaches should be considered only within trials
  • Early pleurodesis should be done if intracavitary treatment is not planned (stages IA, IB)
• The authors' conclusion: The authors' guideline stated that there is no standard treatment for malignant mesothelioma, and that most treatments should be given only within clinical trials

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Mesothelioma.

Related studies

• The next mesothelioma wave: mortality trends and forecast to 2030 in Brazil — E. Algranti, C.A. Saito, et al. (2015)
• Estimation of an optimal chemotherapy utilization rate for malignant pleural mesothelioma: an evidence-based benchmark for cancer care — S.C. Kao, N. van Zandwijk, et al. (2015)
• Local Cancer Recurrence: The Realities, Challenges, and Opportunities for New Therapies — D.A. Mahvi, R. Liu, et al. (2018)
• Therapeutic advances for the tumors associated with neurofibromatosis type 1, type 2, and schwannomatosis — J.O. Blakeley, S.R. Plotkin (2016)
• Development of a guideline on reading CT images of malignant pleural mesothelioma and selection of the reference CT films — H. Zhou, T. Tamura, et al. (2012)
• Management of malignant pleural mesothelioma-part 2: therapeutic approaches : Consensus of the Austrian Mesothelioma Interest Group (AMIG) — M.A. Hoda, T. Klikovits, et al. (2016)

Browse more research in British Journal of Cancer, or return to medical research.