National Cancer Institute®
Last Modified: November 21, 2001
UI - 21256514
AU - Leonardo E; Zanconati F; Bonifacio D; Bonito LD
TI - Immunohistochemical MIB-1 and p27kip1 as prognostic factors in pleural mesothelioma.
SO - Pathol Res Pract 2001;197(4):253-6
AD - Department of Pathology, S. Luigi Gonzaga Hospital, Orbassano, Torino, Italy.
Malignant pleural mesothelioma (MPM) is a tumour that usually presents a short survival time from diagnosis, but in a small number of patients a longer survival time has been observed. We have studied a series of ten long-term and ten short-term survivors with MPM to assess whether the MIB-1 proliferation index and the p27kip1 expression correlated with survival. Our results show significant difference in MIB-1 and in p27kip1 expression between the group of short and longer survival patients. It suggests that the difference in tumour growth fractions may express different biological behaviour and therefore indicate important factors in MPM prognosis.
UI - 21256548
AU - Cappello F; Barnes L
TI - Synovial sarcoma and malignant mesothelioma of the pleura: review, differential diagnosis and possible role of apoptosis.
SO - Pathology 2001 May;33(2):142-8
AD - Institute of Pathological Anatomy, University of Palermo, Italy. firstname.lastname@example.org
Synovial sarcoma of the pleural cavity is exceptionally rare and may be confused, both clinically and histologically, with malignant mesothelioma, with subsequent inappropriate therapy. To address this dilemma, four biphasic synovial sarcomas (BSSs) and four biphasic malignant mesotheliomas (BMMs) were studied with a panel of mucin and immunohistochemical stains to determine if they would allow one to distinguish between the two. The BMMs were all pleural-based. The BSSs were extrapleural. The mucin and immunohistochemical stains were all performed on formalin-fixed, paraffin-embedded tissue using standard techniques, with appropriate positive and negative controls. Mucin present in BSS is, in general, mucicarmine-positive and resistant to both hyaluronidase and diastase. Of the immune markers evaluated, only calretinin, Ber-Ep4 and bcl-2 were of limited discriminatory value. Subsets of cytokeratins, CEA and CD 34 were not helpful. With the exception of bcl-2, the apoptotic markers p53, bax and cpp32 (caspase) also were not useful. However, when the apoptotic stains were viewed collectively, variations in expression between the two tumours raised the possibility that alterations in apoptotic activity might be responsible for their pathogenesis and behavior. The diagnosis of BSS or BMM of the pleural should be made only after total consideration of clinical, radiological, histochemical and immunohistochemical findings. Although mucin stains are useful in differential diagnosis, reliance solely on immunohistochemical markers, with the possible exception of calretinin, Ber-Ep4 and bcl-2, is not dependable. The role of apoptosis in the pathogenesis of these tumours needs to be explored with a much larger series.
UI - 21436100
AU - Emri S; Akbulut H; Zorlu F; Dincol D; Akay H; Gungen Y; Icli F
TI - Prognostic significance of flow cytometric DNA analysis in patients with malignant pleural mesothelioma.
SO - Lung Cancer 2001 Aug-Sep;33(2-3):109-14
AD - Department of Chest Diseases, Hacettepe University Faculty of Medicine, 06100 Ankara, Turkey.
Malignant pleural mesothelioma (MPM) due to environmental exposure to asbestos and erionite is a relatively common cancer in Turkey. In this study, we investigated the value of flow cytometric (FCM) DNA analysis and other prognostic factors such as age and etiologic factor in the patients with MPM, treated with surgery+/-combination chemotherapy+/-radiotherapy. A total of 40 patients with a median age of 50 (range 30-68) were included in the study. Twenty-nine patients had asbestos exposure in etiology, while 11 had fibrous zeolite (erionite). Paraffin-embedded tumor specimens were studied by FCM for DNA analysis. Twelve patients (30%) had aneuploid tumors and 28 (70%) had diploid ones. Mean S-phase fraction (SPF; %) was 9.1+/-1.1 and proliferation index (PI, SPF+G2/M phase; %) was 11.3+/-0.9. While the median overall survival (OS) was 10+/-2 months (6-14; 95% CI), 1-year survival rate was 45.2%. Only PI was found to be statistically significant for OS in univariate analysis (P=0.013). PI was also found to be an independent prognostic factor for all patients (P=0.035). Aneuploidy was significantly higher in erionite group compared with asbestos group. Male predominance and poor survival were also prominent in erionite group, though not statistically significant. In conclusion, PI is an independent prognostic factor for patients with MPM and the biologic features of the disease may show differences with respect to different etiologies.
UI - 21433362
AU - Yano E; Wang ZM; Wang XR; Wang MZ; Lan YJ
TI - Cancer mortality among workers exposed to amphibole-free chrysotile asbestos.
SO - Am J Epidemiol 2001 Sep 15;154(6):538-43
AD - Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan. email@example.com
The issue of whether exposure to chrysotile asbestos alone, without contamination from amphibole asbestos, causes lung cancer and mesothelioma was investigated in a 25-year longitudinal study (1972-1996) in Chongqin, China. The study cohort comprised 515 male asbestos plant workers exposed to chrysotile only; the control cohort included 650 non-dust-exposed workers. The results of analysis in which the proportional hazards model was used indicated that mortality due to all causes, all cancers, and lung cancer was related to asbestos exposure; the relative risks, adjusted for age and smoking, were 2.9, 4.3, and 6.6, respectively. Fiber concentrations in the raw material section and the textile section of the plant were 7.6 and 4.5 fibers/ml, respectively. Because of differences between the study and control plants, the authors also compared various sections of the asbestos plant that had different levels of dust exposure. The adjusted relative risk of lung cancer was 8.1 for workers exposed to high versus low levels of asbestos. Two cases of malignant mesothelioma, one pleural and the other peritoneal, were found in the asbestos cohort. These results suggest that heavy exposure to pure chrysotile asbestos alone, with negligible amphibole contamination, can cause lung cancer and malignant mesothelioma in exposed workers.
UI - 21455249
AU - Thylen A; Hjerpe A; Martensson G
TI - Hyaluronan content in pleural fluid as a prognostic factor in patients with malignant pleural mesothelioma.
SO - Cancer 2001 Sep 1;92(5):1224-30
AD - Division of Pulmonary Medicine, Sahlgrenska University Hospital, Goteborg, Sweden. firstname.lastname@example.org
BACKGROUND: Regardless of the modality of therapy used, malignant pleural mesothelioma is a highly treatment-resistant and invariably fatal disease. Identification of prognostic variables are important for future investigational therapeutic studies. METHODS: The prognostic significance of various clinical variables, including hyaluronan levels in pleural fluid, was evaluated in a retrospective analysis in 100 patients with histologically confirmed malignant pleural mesothelioma. RESULTS: The overall median survival was 11.5 months. Univariate analyses identified histologic subtype, i.e., epithelial or mixed, and elevated content of hyaluronan in the pleural effusion as significant prognostic variables. A multivariate analysis confirmed the independent predictive power of histologic subtype, and an elevated concentration of hyaluronan in the pleural fluid also indicated longer survival in older patients and in patients receiving therapy other than supportive. CONCLUSIONS: The prognostic value of histologic subtype and the concentration of hyaluronan in pleural effusions should be considered when designing and evaluating treatment trials for patients with malignant pleural mesothelioma. Copyright 2001 American Cancer Society.
UI - 21455252
AU - Bongiovanni M; Cassoni P; De Giuli P; Viberti L; Cappia S; Ivaldi C;
TI - Chiusa L; Bussolati G p27(kip1) immunoreactivity correlates with long-term survival in pleural malignant mesothelioma.
SO - Cancer 2001 Sep 1;92(5):1245-50
AD - Department of Oncology, University of Turin, Turin, Italy.
BACKGROUND: Pleural malignant mesothelioma (PMM) is a rare and highly aggressive tumor, whose development is strictly related to occupational exposure to asbestos. The prognosis of PMM is generally poor (median survival, 4-12 months), but a few have a relatively long survival. The objective of this study was to evaluate the use of the cell cycle-related proteins p27(kip1) and MIB-1 as prognostic indicators of survival in PMMs. METHODS: Of 621 PMMs, the authors selected 27 cases with a relatively long-term survival (> 24 months) and a control group of 36 PMMs having a shorter (usual) survival (< 24 months). RESULTS: The expression of the p27(kip1) was significantly higher in the long-term survival group compared with the control (short survival) group (81.41% vs. 31.94%; P < 0.0001). The PMMs of epithelioid histotype had a significantly higher p27(kip1) immunoreactivity compared with those of biphasic type (59.24% vs. 38.94%; P = 0.02). In agreement with the data in the literature, the proliferative activity (as detected by MIB-1 immunoreactivity) was significantly higher in short than long survival PMMs (43.53% vs. 14.11%; P < 0.0001) and in the biphasic histotype than in the epithelioid type (43.19% vs. 26.02%; P = 0.006). CONCLUSIONS: The combined expression of high/low p27(kip1) and low/high Ki-67 values identified with 100% specificity and sensitivity long versus short survivors. p27(kip1) represents a reliable additional predictive factor for PMMs and a useful marker to identify patients having a more favorable prognosis. Copyright 2001 American Cancer Society.
UI - 20108485
AU - Gennaro V; Finkelstein MM; Ceppi M; Fontana V; Montanaro F; Perrotta A;
TI - Puntoni R; Silvano S Mesothelioma and lung tumors attributable to asbestos among petroleum workers.
SO - Am J Ind Med 2000 Mar;37(3):275-82
AD - Environmental Epidemiology and Biostatistics, National Cancer Institute, Genoa, Italy. email@example.com
BACKGROUND: Asbestos exposure has been definitively found to be associated with both mesothelioma and lung cancer. Nevertheless, in the overall population of oil refinery workers potentially exposed to asbestos, many studies clearly show a definitely increased risk of mesothelioma, but no proven excess of lung cancer after comparison to the general population. Through the presentation of new data and the re-appraisal of two recent and independent epidemiological studies conducted in Liguria, Italy, and Ontario, Canada, we attempt to shed light on this apparently paradoxical finding. METHODS: Lung cancer mortality was studied among maintenance workers exposed to asbestos, and among two other subgroups of refinery employees: blue collar and white collar workers. The comparison with blue collar workers was performed in order to take into account the role of healthy worker effect, smoking habit, and the socioeconomic level. The comparison with white collar workers was performed to control for other occupational lung carcinogens. RESULTS AND CONCLUSIONS: Results reveal a consistency between the two studies and show that 96-100% of the mesotheliomas and 42-49% of the lung tumors arising among maintenance workers were attributable to asbestos exposure. Our new analysis, estimating two cases of asbestos-related lung cancer for each case of mesothelioma, confirms published findings on the magnitude of asbestos-related tumors in oil refineries. Copyright 2000 Wiley-Liss, Inc.
UI - 21231507
AU - Tsai SP; Waddell LC Jr; Ransdell JC
TI - RE: Mesothelioma and lung tumors attributable to asbestos among petroleum workers. Am. J. Ind. Med. 2000. 37:275-282.
SO - Am J Ind Med 2001 May;39(5):515-21
UI - 21231510
AU - Ludwig ER; Madeksho L; Egilman D
TI - RE: Mesothelioma and lung tumors attributable to asbestos among petroleum workers. Am. J. Ind. Med. 2000. 37:275-282.
SO - Am J Ind Med 2001 May;39(5):524-7
UI - 21150749
AU - Lane T
TI - Tumour of the spermatic cord: an unusual primary manifestation of an epithelial mesothelioma of the peritoneum with patent processus vaginalis.
SO - BJU Int 2001 Mar;87(4):415
UI - 21291614
AU - Steele JP; O'Doherty CA; Shamash J; Evans MT; Gower NH; Tischkowitz MD;
TI - Rudd RM Phase II trial of liposomal daunorubicin in malignant pleural mesothelioma.
SO - Ann Oncol 2001 Apr;12(4):497-9
AD - Department of Medical Oncology, St. Bartholomew's Hospital, Royal Free and University College Medical School, London, UK. firstname.lastname@example.org
BACKGROUND: To assess the response rate, toxicity and survival in patients with malignant pleural mesothelioma treated with liposomal daunorubicin. The study design allowed for dose escalation pending toxicity. PATIENTS AND METHODS: Liposomal daunorubicin (DaunoXome, Nexstar, USA) 120 mg/m2 was administered every 21 days to a maximum of 6 cycles. Patients had to have histologically-proven malignant pleural mesothelioma. Patients were all chemotherapy-naive with ECOG performance status 0-2. RESULTS: Fourteen patients were enrolled. There were no objective or symptomatic responses though nine patients (64%) had stable disease on therapy. Myelosuppression was the major toxicity with 9 of 11 patients evaluable for toxicity experiencing grade 3 or 4 neutropenia. Other toxicities seen in at least 30% of patients included grade 3 infection and grade 2 nausea and vomiting. The median overall survival by intention-to-treat analysis was 6.1 months from the time of first treatment. The median duration of stable disease from time of first treatment for patients not progressing on therapy was 5.1 months. CONCLUSIONS: Liposomal daunorubicin 120 mg/m2 has no useful clinical activity in patients with malignant pleural mesothelioma. Toxicity was substantial with most patients experiencing at least one episode of grade 3 or 4 neutropenia. Liposomal daunorubicin cannot be recommended for patients with malignant pleural mesothelioma.
UI - 21437043
AU - Knuuttila A; Kivisaari L; Kivisaari A; Palomaki M; Tervahartiala P;
TI - Mattson K Evaluation of pleural disease using MR and CT. With special reference to malignant pleural mesothelioma.
SO - Acta Radiol 2001 Sep;42(5):502-7
AD - Department of Medicine, Division of Respiratory Disease, Helsinki University Central Hospital, Helsinki, Finland.
PURPOSE: To evaluate MR imaging and CT in differentiating malignant pleural mesothelioma from other malignancies or benign pleural disease. MATERIAL AND METHODS: Thirty-four patients (18 pleural mesotheliomas, 9 other malignancies, 7 benign pleural diseases) were examined using enhanced CT and MR. Two radiologists reviewed the CT and two others the MR images. Comparisons were made between the diagnostic groups and the imaging methods. RESULTS: The abnormalities commonly found in malignant disease, but significantly less frequently in benign pleural disease, were focal thickening and enhancement of interlobar fissures. In mesothelioma, enhancement of interlobar fissures, tumour invasion of the diaphragm, mediastinal soft tissue or chest wall, were significantly more often observed than in other malignancies and MR was the most sensitive method. In other malignancies, invasion of bony structures was a more common finding and was also better shown by MR. The contrast-enhanced T1 fat-suppressed (CET1fs) sequence detected these features better than other MR sequences. CONCLUSION: MR, especially the CET1fs sequence in three planes, gave more information than enhanced CT. Focal thickening and enhancement of interlobar fissures were early abnormalities indicating malignant pleural disease. MR could be clinically useful for differentiating mesothelioma from other pleural diseases.
UI - 21477321
AU - De Rienzo A; Balsara BR; Apostolou S; Jhanwar SC; Testa JR
TI - Loss of heterozygosity analysis defines a 3-cM region of 15q commonly deleted in human malignant mesothelioma.
SO - Oncogene 2001 Sep 27;20(43):6245-9
AD - Human Genetics Program, Fox Chase Cancer Center, Philadelphia, PA 19111, USA.
Previous comparative genomic hybridization and allelic loss analyses demonstrated frequent deletions from 15q11.1-15 in malignant mesothelioma. Recurrent losses of 15q11-22 have also been reported in several other tumor types such as breast and colorectal cancers. To more precisely map the commonly deleted region, we have performed a high density loss of heterozygosity analysis of 46 malignant mesotheliomas, using 26 polymorphic microsatellite markers spanning the entire long arm of chromosome 15. Allelic loss from 15q was observed in 22 of 46 (48%) cases. These analyses have defined a minimally deleted region of approximately 3-cM, which was confirmed to reside at 15q15 by fluorescence in situ hybridization analysis with yeast artificial chromosome probes. No tumor suppressor genes have been reported to map to this site. The minimally deleted region identified in this investigation overlaps those observed in other kinds of cancer, and is the smallest site of recurrent 15q loss identified to date in human tumors. The identification of this commonly deleted site implicates a putative tumor suppressor gene(s) at 15q15 involved in diverse forms of human neoplasia.
UI - 21441433
AU - Edwards JG; Cox G; Andi A; Jones JL; Walker RA; Waller DA; O'Byrne KJ
TI - Angiogenesis is an independent prognostic factor in malignant mesothelioma.
SO - Br J Cancer 2001 Sep 14;85(6):863-8
AD - University Department of Medical Oncology, Leicester Royal Infirmary, Osborne Building, Leicester LE1 5WW, UK.
Angiogenesis is essential for tumour growth beyond 1 to 2 mm in diameter. The clinical relevance of angiogenesis, as assessed by microvessel density (MVD), is unclear in malignant mesothelioma (MM). Immunohistochemistry was performed on 104 archival, paraffin-embedded, surgically resected MM samples with an anti-CD34 monoclonal antibody, using the Streptavidin-biotin complex immunoperoxidase technique. 93 cases were suitable for microvessel quantification. MVD was obtained from 3 intratumoural hotspots, using a Chalkley eyepiece graticule at x 250 power. MVD was correlated with survival by Kaplan-Meier and log-rank analysis. A stepwise, multivariate Cox model was used to compare MVD with known prognostic factors and the EORTC and CALGB prognostic scoring systems. Overall median survival from the date of diagnosis was 5.0 months. Increasing MVD was a poor prognostic factor in univariate analysis (P = 0.02). Independent indicators of poor prognosis in multivariate analysis were non-epithelial cell type (P = 0.002), performance status > 0 (P = 0.003) and increasing MVD (P = 0.01). In multivariate Cox analysis, MVD contributed independently to the EORTC (P = 0.006), but not to the CALGB (P = 0.1), prognostic groups. Angiogenesis, as assessed by MVD, is a poor prognostic factor in MM, independent of other clinicopathological variables and the EORTC prognostic scoring system. Further work is required to assess the prognostic importance of angiogenic regulatory factors in this disease. Copyright 2001 Cancer Research Campaign http://www.bjcancer.com.
UI - 21487360
AU - Metintas M; Metintas S; Ucgun I; Gibbs AR; Harmanci E; Alatas F; Erginel
TI - S; Tel N; Pasaoglu O Prognostic factors in diffuse malignant pleural mesothelioma: effects of pretreatment clinical and laboratory characteristics.
SO - Respir Med 2001 Oct;95(10):829-35
AD - Department of Chest Diseases, Osmangazi University Medical Faculty, Eskisehir, Turkey. email@example.com
The aim of this study was to investigate the effects of various pretreatment clinical and laboratory characteristics on the survival of patients with diffuse malignant pleural mesothelioma (DMPM). One hundred histopathologically confirmed DMPM patients were evaluated. Fifty-nine were treated with chemoimmunotherapy while 41 who had refused chemoimmunotherapy received supportive therapy alone. The following pretreatment characteristics were evaluated in both univariate and multivariate Cox regression analyses: age, gender, Karnofsky performance score (KPS), histology asbestos exposure, presence of chest pain, dyspnoea, weight loss, symptom duration, smoking history, disease location, platelet count, haemoglobin, white blood cell (WBC) count, serum lactate dehydrogenase (LDH) and extent of disease (stage). Univariate analysis showed that patients with age > or = 75 years, male gender, smoking history advanced stages above stage I disease, KPS < 70, WBC count > or = 8450 and LDH level > or = 500 IU l(-1) have a worse prognosis. With multivariate Cox regression analyses, age > or = 75 years, advanced stages above stage I disease, KPS < 70 and LDH level > or = 500 IU l(-1) were found to be indicators of a poorer prognosis. In conclusion, in our study each of low performance status, older age, advanced stage disease, high LDH level and prognosis were found to be related.
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