National Cancer Institute®
Last Modified: March 1, 2002
1
UI - 11836665
AU - Britton M
TI -
The epidemiology of mesothelioma.
SO - Semin Oncol 2002 Feb;29(1):18-25
AD - Department of Respiratory Medicine, Ashford and St Peter's Hospitals NHS
Trust, Chertsey, Surrey, UK.
It has been more than 40 years since occupational crocidolite exposure
in South African miners was found to be associated with development of
malignant mesothelial tumors 30 to 40 years later. Similar cases were
not seen in the amosite and chrysotile miners. Since then,
epidemiological and toxicological knowledge have increased enormously,
but mortality continues to rise steeply (5% to 10% per year) in most
industrialized countries. Even with widespread asbestos abatement
efforts, this increase is likely to continue in Western Europe and the
United State well into the next century, at least until 2020.
Unregulated use of asbestos in less industrialized countries may cause
the epidemic to continue throughout the next century in those regions.
Asbestos abatement seems to be successful as evidenced by a decline in
the proportion of patients with peritoneal tumors, which are the most
common malignancies in heavily exposed individuals. Whereas in the 1960s
peritoneal tumors comprised up to 30% of the total, in recent years the
proportion has fallen to about 10%, This changing ratio could also be
due to the steady increase in pleural tumors. The difficulty in
formulating the connection as to the etiology of mesothelioma resulted
from an unforeseeable difference in the carcinogenicity of various
asbestos and mineral fiber types and was compounded by the very long
latency of the disease. Unfortunately, the use of a single term,
"asbestos," to describe at least five fibrous silicate minerals, each
with unique physical, chemical, and biological properties and not
infrequently and naturally admixed, severely hampered scientific
investigation into the occupational health risks. The field became
confused and filled with debate. At the heart of the fiber type
controversy lies a fundamentally differing view of the importance of
biopersistence of various asbestos fibers in carcinogenesis. This review
will deal with the epidemiology of mesothelioma with particular
attention to the studies that elucidate the impact of various asbestos
fiber types on the etiology of the disease. Copyright 2002 by W.B.
Saunders Company.
2
UI - 11836666
AU - Marom EM; Erasmus JJ; Pass HI; Patz EF Jr
TI -
The role of imaging in malignant pleural mesothelioma.
SO - Semin Oncol 2002 Feb;29(1):26-35
AD - Department of Radiology, Duke University Medical Center, Durham, NC
27710, USA.
Imaging plays an essential role in the diagnosis, staging, and follow-up
of patients with malignant pleural mesothelioma (MPM). The diagnosis is
often suggested by a unilateral pleural mass with a moderate to large
pleural effusion seen on chest radiographs, but computerized tomography
(CT) is the most frequently used technique for evaluation of the lungs
in patients with MPM. CT not only suggests pulmonary metastases
typically manifested as nodules or masses, but also can demonstrate
underlying lung disease often caused by prior asbestos exposure.
Magnetic resonance (MR) imaging may be helpful in selected patients with
potentially resectable disease to further examine the local extent of
tumor. Imaging with positron emission tomography (PET) using the
radionuclide imaging agent (18)F fluoro-deoxyglucose (FDG) takes
advantage of a basic property of tumor cells, increased glucose
metabolism to identify malignant lesions. PET provides not only anatomic
information, especially regarding mediastinal node metastasis, but also
biochemical information about the lesion. These imaging modalities help
triage patients to the most appropriate diagnostic and treatment
options. Following patients after therapy usually relies on chest
radiographs, although CT can more accurately describe response to
therapy. This review will focus on radiologic evaluation in diagnosing,
staging, and follow-up patients with MPM. Copyright 2002 by W.B.
Saunders Company.
3
UI - 11836667
AU - Steele JP
TI -
Prognostic factors in mesothelioma.
SO - Semin Oncol 2002 Feb;29(1):36-40
AD - Department of Medical Oncology, St Bartholomew's Hospital, London,
England.
Prognostic factors in oncology may help physicians give their patients a
prognosis for their disease and thus allow them to make plans for the
future. These factors also assist in the selection of patients more
likely to benefit from intensive treatments, especially in the context
of clinical trials. Recently it has become clear that prognostic factors
may have an additional benefit: they may provide insight into the
biology of the cancer being studied and lead to improved understanding
of the molecular pathogenesis. For malignant mesothelioma, the
prognostic scoring systems of the Cancer and Leukemia Group B (CALGB)
and European Organization for Research and Treatment of Cancer (EORTC)
are the most useful of those currently available. These systems rate
performance status, age, histological subtype, weight loss, and
hematological parameters as the best prognostic factors for malignant
mesothelioma. In the future, biological markers may provide additional
information on mesothelioma and will help in prognostication. Copyright
2002 by W.B. Saunders Company.
4
UI - 11836668
AU - Zellos LS; Sugarbaker DJ
TI -
Multimodality treatment of diffuse malignant pleural mesothelioma.
SO - Semin Oncol 2002 Feb;29(1):41-50
AD - Department of Surgery, Division of Thoracic Surgery, Brigham and Women's
Hospital, Boston, MA 02115, USA.
Diffuse malignant pleural mesothelioma (DMPM) is a challenging disease
in all of its aspects, from presentation and diagnosis to staging and
treatment. Single-modality therapy was the initial approach to this
disease. It generally has not been effective in changing the natural
history of DMPM. As a result, multimodality regimens involving surgery
with radiation, chemotherapy, or immunotherapy delivered regionally or
systemically have been evaluated. Randomized controlled studies
comparing various strategies are lacking and, thus, the debate continues
regarding the effectiveness of different treatment approaches. Copyright
2002 by W.B. Saunders Company.
5
UI - 11836669
AU - Sugarbaker PH; Acherman YI; Gonzalez-Moreno S; Ortega-Perez G; Stuart
TI -
OA; Marchettini P; Yoo D
Diagnosis and treatment of peritoneal mesothelioma: The Washington
Cancer Institute experience.
SO - Semin Oncol 2002 Feb;29(1):51-61
AD - Washington Cancer Institute, Washington, DC 20010, USA.
Peritoneal mesothelioma is a rare disease, but increasing in frequency.
The incidence is approximately one per 1,000,000 and about one fifth to
one third of all mesotheliomas are peritoneal. Because of its unusual
nature, the disease has not been clearly defined either in terms of its
natural history, diagnosis, or management. This article reviews a single
institution's experience with 51 patients prospectively treated over the
past decade with increasingly aggressive local/regional protocols.
Peritoneal mesothelioma patients generally present with two types of
symptoms and signs; those with abdominal pain, usually localized and
related to a dominant tumor mass with little or no ascites and those
without abdominal pain, but with ascites and abdominal distention.
Pathologically, a positive immunostain for calretinin has markedly
increased the accuracy of diagnosis. Prognosis as determined by clinical
presentation, the completeness of cytoreduction, and gender (females
survive longer than males) appears to be improved by the use of
intraperitoneal chemotherapy. Over the past decade, the management of
these patients has evolved similarly to ovarian cancer treatment and now
involves cytoreductive surgery, heated intraoperative intraperitoneal
chemotherapy (HIIC) with cisplatin and doxorubicin, and early
postoperative intraperitoneal paclitaxel. These perioperative treatments
are followed by adjuvant intraperitoneal paclitaxel and second-look
cytoreduction. Prolonged disease-free survival and reduced adverse
symptoms with the current management strategy are documented by a high
complete response rate as assessed by a negative second-look. This
multimodality treatment approach with cytoreductive surgery and
intraperitoneal chemotherapy has resulted in a median survival of 50 to
60 months. Peritoneal mesothelioma is an orphan disease that is
treatable with expectations for "potential" cure in a small number of
patients if diagnosed and treated early with definitive local/regional
treatments. A prolonged high quality of life is possible in the majority
of patients. Copyright 2002 by W.B. Saunders Company.
6
UI - 11836670
AU - Baas P
TI -
Chemotherapy for malignant mesothelioma: from doxorubicin to
vinorelbine.
SO - Semin Oncol 2002 Feb;29(1):62-9
AD - Department of Thoracic Oncology, The Netherlands Cancer Institute,
Amsterdam, The Netherlands.
It has been a challenge to find effective chemotherapeutic treatments
for malignant mesothelioma. Over the last several decades numerous
single-drug and combination regimens have been examined, but no standard
treatment with chemotherapy alone has emerged. Possible explanations for
this lack of success are the heterogeneity between the different
subclasses of mesothelioma and the difficulties experienced in
determining responses on computed tomographic (CT) scan. This review
will present the results of most chemotherapy trials. An attempt is also
been made to overcome the problem of identifying the overall response
rate by presenting the median survival time. Other types of response
evaluation and guidelines for patient selection are warranted to
properly compare chemotherapeutic treatments. Copyright 2002 by W.B.
Saunders Company.
7
UI - 11836671
AU - Kindler HL; van Meerbeeck JP
TI -
The role of gemcitabine in the treatment of malignant mesothelioma.
SO - Semin Oncol 2002 Feb;29(1):70-6
AD - Section of Hematology/Oncology, University of Chicago, Chicago, IL
60637, USA.
Gemcitabine is broadly active in a variety of solid tumors, including
malignant mesothelioma. In vitro, gemcitabine demonstrates activity
against mesothelioma cell lines. The role of single-agent gemcitabine in
patients with mesothelioma is unclear, since three phase II trials
treated a total of 60 patients and achieved response rates of 0%, 7%,
and 31%. The combination of gemcitabine and cisplatin is synergistic
against mesothelioma cell lines in vitro. Gemcitabine in combination
with cisplatin or carboplatin shows definite activity in phase II
trials. The trial by Byrne and colleagues that demonstrated a response
rate of 48% established the combination of gemcitabine plus cisplatin as
a standard therapy for this disease in the United States. Subsequent
multicenter trials have achieved lower response rates of 26% and 16% for
this combination. Gemcitabine plus carboplatin also has activity. Future
roles for gemcitabine in malignant mesothelioma patients include
incorporating a gemcitabine/platinum regimen for neoadjuvant or adjuvant
therapy, combining it with other cytotoxic chemotherapy agents such as
pemetrexed or vinorelbine, or adding novel cytostatic agents such as the
vascular endothelial growth factor (VEGF) inhibitor, bevacizumab, to the
gemcitabine and platinating agent combination. Copyright 2002 by W.B.
Saunders Company.
8
UI - 11836672
AU - Fizazi K; John WJ; Vogelzang NJ
TI -
The emerging role of antifolates in the treatment of malignant pleural
mesothelioma.
SO - Semin Oncol 2002 Feb;29(1):77-81
AD - Institut Gustave Roussy, Villejuif, France.
Clinicians have long regarded malignant pleural mesothelioma as a
chemoresistant neoplasm and as a result no standard chemotherapy regimen
has emerged. Antifolates such as methotrexate are among the most active
compounds in mesothelioma, albeit based only on phase II data. Recently
two antifolate-based combinations with apparently higher efficacy than
older regimens have emerged: the pemetrexed/cisplatin regimen and the
raltitrexed/oxaliplatin regimen. In two phase I trials with pemetrexed
combined with either cisplatin or carboplatin responses occurred in five
of 11 and nine of 29 patients, respectively. In a phase I trial of
raltitrexed/oxaliplatin, six of 17 patients (35%) with mesothelioma
achieved a partial response. In a phase II trial of
raltitrexed/oxaliplatin, 14 objective responses were confirmed in 72
patients (25%) with malignant pleural mesothelioma. Indeed, responses
were seen in cisplatin-refractory patients. Based on the promising
results from these combination trials, two large phase III studies have
begun. The first study was a multicenter, multinational trial sponsored
by Eli Lilly and Company, which randomized more than 430 patients with
malignant pleural mesothelioma to cisplatin with or without pemetrexed.
trial ever conducted in mesothelioma. The second trial is being
conducted by the European Organization for the Research and Treatment of
Cancer (EORTC) and compares cisplatin with or without raltitrexed with
planned accrual of 240 patients. In both trials, survival is the main
endpoint. These trials will help to define the role of these new
antifolates in malignant pleural mesothelioma. Copyright 2002 by W.B.
Saunders Company.
9
UI - 11836674
AU - Girling DJ; Muers MF; Qian W; Lobban D
TI -
Multicenter randomized controlled trial of the management of
unresectable malignant mesothelioma proposed by the British Thoracic
Society and the British Medical Research Council.
SO - Semin Oncol 2002 Feb;29(1):97-101
AD - Medical Research Council, Clinical Trials Unit, Cancer Division, London,
United Kingdom.
Malignant mesothelioma is almost invariably fatal. The incidence of the
disease is rising rapidly in many countries, and there is no generally
accepted standard treatment for patients with unresectable disease.
According to current British Thoracic Society (BTS) guidelines, patients
should be treated with active symptom control (ASC), involving (1)
regular follow-up in a specialist clinic; (2) structured assessments of
physical, psychological and social problems with appropriate action; (3)
rapid involvement of additional specialists; and (4) parallel nursing
support. Although many nonrandomized studies have reported tumor
responses to anticancer chemotherapy, few have studied palliation and it
is not known whether chemotherapy prolongs survival or provides
clinically worthwhile palliation with acceptable toxicity when given in
addition to ASC. We therefore plan to conduct a multicenter randomized
controlled trial comparing (1) ASC alone, (2) ASC plus mitomycin
vinblastine and cisplatin (MVP), and (3) ASC plus vinorelbine (N;
Navelbine, Pierre Fabre Oncology, Winchester, UK). We chose these
chemotherapy regimens because they have been shown in nonrandomized
studies to provide good symptom control as recorded by patients. The
outcome measures are overall survival, palliation of symptoms,
performance status, analgesic usage, toxicity, quality of life, tumor
response, and recurrence/progression-free survival. In a preliminary
feasibility study, we are assessing the acceptability of the trial
design to patients and the suitability of two standard quality-of-life
instruments in mesothelioma. Data will help us to decide the final
details of the large multicenter trial. Copyright 2002 by W.B. Saunders
Company.
10
UI - 11857086
AU - Foddis R; De Rienzo A; Broccoli D; Bocchetta M; Stekala E; Rizzo P;
TI -
Tosolini A; Grobelny JV; Jhanwar SC; Pass HI; Testa JR; Carbone M
SV40 infection induces telomerase activity in human mesothelial cells.
SO - Oncogene 2002 Feb 21;21(9):1434-42
AD - Cancer Immunology Program, Department of Pathology, Cardinal Bernardin
Cancer Center, Loyola University Chicago, Maywood, Illinois, IL 60153,
USA.
Mesotheliomas are malignant tumors of the pleural and peritoneal
membranes which are often associated with asbestos exposure and with
Simian virus 40 (SV40) infection. Telomerase activity is repressed in
somatic cells and tissues but is activated in immortal and malignant
cells. We evaluated telomerase activity in seven primary malignant
mesothelioma biopsies and matched lung specimens and 20 mesothelioma
cell lines and eight corresponding primary tumor cultures. All the tumor
biopsies, and nearly all primary cell mesothelioma cultures and cell
lines were telomerase positive. The findings in cell lines paralleled
those observed in primary cultures in cases where paired samples were
available. Next, we found that SV40, a DNA tumor virus present in
approximately 50% of mesothelioma biopsies in the USA, induced
telomerase activity in primary human mesothelial cells, but not in
primary fibroblasts. Telomerase activity became detectable as early as
72 h following wild-type (strain 776) SV40 infection, and a clear DNA
ladder was detectable 1 week after infection. The amount of telomerase
activity increased during passage in cell culture and appeared to
parallel increases in the cellular amounts of the SV40 large T-antigen.
Thus, SV40 infection leads to telomerase activity before the infected
mesothelial cells become transformed and immortalized. SV40 infection of
human fibroblasts did not cause detectable telomerase activity. We also
determined that the SV40 small t-antigen (tag) plays an important role
in inducing telomerase activity because this activity was undetectable
or minimal in mesothelial cells infected and/or transformed by SV40 tag
mutants. Asbestos alone did not induce telomerase activity, and asbestos
did not influence telomerase activity in mesothelial cells infected with
SV40. Induction of telomerase activity by SV40 may be related to the
very high rate of mesothelial cell immortalization that is
characteristically associated with SV40 infection of mesothelial cells.
11
UI - 11850833
AU - Klein G; Powers A; Croce C
TI -
Association of SV40 with human tumors.
SO - Oncogene 2002 Feb 14;21(8):1141-9
AD - Microbiology and Tumor Biology Center, Karolinska Institut, S 171-77,
Stockholm, Sweden.
In 1994, PCR and protein studies suggested that SV40 DNA sequences and
proteins were present in 29/48 (60%) USA human mesothelioma samples.
Sequence analysis confirmed that the sequences were homologous to SV40.
One year later, SV40 was also found in 5/9 human mesotheliomas, and in
1996 SV40 was also reported to be present in 1/3 of the tumor specimens
examined. These reports, in combination with an earlier study in 1992
which had detected SV40 in human brain tumors, raised concerns that SV40
was associated with certain types of human tumors, specifically
mesothelioma, bone, and brain tumors. These findings raised concerns,
because these tumor types are the same malignancies that had been
observed in animals injected with SV40. However, a study in 1996 and a
presentation made at the International Mesothelioma Interest Group, IMIG
in 1997 failed to detect SV40 in mesotheliomas, suggesting the
possibility that laboratory artifacts, such as PCR contamination, had
caused the previous positive findings. In 1997, the FDA, the NIH, and
the CDC organized an international conference in Bethesda to review the
literature and to address the possibility that SV40 was present in, and
was possibly the cause of, some human tumors. The results of that
conference were reported the same year in a meeting review in Oncogene
by Carbone and colleagues. Briefly, the consensus was that before
accepting the possibility that SV40 was present in human tumors, a
multi-laboratory study needed to be conducted. It was recommended that a
blinded multi-laboratory study be directed by an independent scientist
not previously associated with the controversial reports of SV40 in
human specimens. It was also recommended that this study include
laboratories that had reported positive findings as well as laboratories
that had failed to detect SV40 in human specimens. Since 1997, about 30
independent reports have been published on this topic, including the
multi-laboratory study. Evidence in favor and against a possible
association of SV40 with human cancer was reviewed at an international
entitled "Malignant Mesothelioma: Therapeutic Options and the Role of
SV40, 2001". The main focus was the association of SV40 with
mesothelioma and other human tumors. At the end of the meeting, a panel
discussion, which included independent experts who had not published on
this topic, critically reviewed the evidence presented at the meeting.
The results of the meeting and of the final panel discussion are
outlined below.
12
UI - 11869020
AU - Begossi G; Gonzalez-Moreno S; Ortega-Perez G; Fon LJ; Sugarbaker PH
TI -
Cytoreduction and intraperitoneal chemotherapy for the management of
peritoneal carcinomatosis, sarcomatosis and mesothelioma.
SO - Eur J Surg Oncol 2002 Feb;28(1):80-7
AD - The Washington Cancer Institute, Washington Hospital Center, Washington,
DC 20005, USA.
Despite new developments in multi-modality treatments, complete
resection remains as an absolute requirement for cure of
gastrointestinal cancer. We have reported benefits from combined
treatment with complete cytoreduction and intraperitoneal chemotherapy.
This has been achieved with low morbidity and mortality. Success in the
surgical management of peritoneal surface malignancy depends on the
surgeon's ability to complete complex cytoreductive procedures so that
only microscopic residual disease remains. This paper describes the
current strategy that the surgical oncologist should pursue in the
treatment of patients with peritoneal carcinomatosis, sarcomatosis and
mesothelioma. Technical details required for this surgery include
patient position, incision and exposure, complete lysis of adhesion,
electroevaporative dissection with irrigation and suction to preserve
the translucent quality of tissues, peritonectomy procedures, proper
positioning of tubes and drains for intraperitoneal chemotherapy, and
reconstructive surgery. Understanding the treatment and mastery of
surgical skills to manage the peritoneal surface spread of cancer has
led to long-term survival of selected patients. Combination of this
treatment strategy with proper patient selection has reduced the
mortality and morbidity. The success of cytoreductive surgery and
perioperative intraperitoneal chemotherapy depends on a long-term
dedication to achieve the full potential of a curative outcome. Our unit
has continued to achieve good results over two decades as improved
results of treatment have evolved. Copyright Harcourt Publishers
Limited.
13
UI - 11333415
AU - Bailey WJ
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):513-4, 522-3; discussion 517-21
14
UI - 11333416
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; discussion 517-21
15
UI - 11717014
AU - Martin-Ucar AE; Edwards JG; Rengajaran A; Muller S; Waller DA
TI -
Palliative surgical debulking in malignant mesothelioma. Predictors of
survival and symptom control.
SO - Eur J Cardiothorac Surg 2001 Dec;20(6):1117-21
AD - Department of Thoracic Surgery, Glenfield Hospital, Groby Road,
Leicester LE3 9QP, UK.
OBJECTIVE: Malignant mesothelioma (MM) typically presents at an advanced
stage. In the UK surgical intervention has been mostly reserved for
tissue diagnosis or chemical pleurodesis. However, the role of debulking
surgery in symptom control has not been fully explored. METHODS: In a
prospective cohort study, 51 consecutive patients presenting with MM
underwent palliative surgical debulking for symptomatic relief (all
patients presented with dyspnoea, 39 also had pain and two had a
co-existing pleural empyema). Patients with early disease who underwent
extrapleural pneumonectomy were excluded. The treatment aims were
pleural drainage, lung re-expansion, pleurodesis and pleural debulking
for symptom control. If the lung re-expanded after drainage of the
effusion a subtotal parietal pleurectomy was performed via Video
Assisted Thoracic Surgery (VATS). If the lung remained entrapped, a
parietal and visceral decortication using VATS or thoracotomy was
performed. The changes in subjective dyspnoea and pain scores were
recorded at 6 weeks and 3, 6 and 12 months after surgery. Prognostic
factors were analyzed to determine their influence on survival and
symptom control. RESULTS: VATS pleurectomy was possible in 17 patients
(34%), whilst decortication was required in the remainder (three by VATS
and 31 by thoracotomy). Median postoperative stay was 7 days (range
2-17) with 30-day mortality of 7.8% (four of 51 patients). Morbidity
included postoperative empyema in two patients (4%) and prolonged
air-leak in five (9.8%). Overall significant symptomatic benefit was
obtained up to 3 months after surgery but subsequently increasing
mortality offset these benefits. Epithelial cell type and absence of
weight loss prior to surgery were found to predict longer survival and
successful symptom control. CONCLUSIONS: Debulking surgery has a
beneficial role in symptom control for unresectable MM. However, this
surgery should be reserved for those patients who present with
epithelial cell type and before significant loss of weight.
16
UI - 10672054
AU - Delahunt B; Eble JN; King D; Bethwaite PB; Nacey JN; Thornton A
TI -
Immunohistochemical evidence for mesothelial origin of paratesticular
adenomatoid tumour.
SO - Histopathology 2000 Feb;36(2):109-15
AD - Departments of Pathology, Wellington School of Medicine, University of
Otago, New Zealand. bd@wnmeds.ac.nz
AIMS: To investigate the histogenesis of paratesticular adenomatoid
tumour by use of immunohistochemical markers for a variety of carcinomas
and mesothelioma. METHODS AND RESULTS: Immunohistochemical staining of
sections from 12 cases of paratesticular adenomatoid tumour was
undertaken using primary antibodies to antigens expressed by benign
epithelial cells and carcinoma (cytokeratin AE1/AE3, cytokeratin
34ssE12, epithelial membrane antigen, MOC-31, Ber-EP4, CEA, B72.3,
LEA.135, Leu M1), stromal and vascular markers (vimentin, CD34, factor
VIII), and mesothelioma-associated antigens (thrombomodulin, HBME-1, OC
125) and p53 protein. There was absence of immunohistochemical
expression of epithelial/carcinoma markers MOC-31, Ber-EP4, CEA, B72.3,
LEA.135, Leu M1 and to factor VIII and CD34. All tumours expressed
cytokeratin AE1/AE3, epithelial membrane antigen and vimentin, with weak
expression of cytokeratin 34ssE12 in 25% of tumours. Each tumour showed
expression of thrombomodulin, HBME-1 and OC 125 in a membranous
distribution. p53 protein expression was not detected. CONCLUSIONS: The
immunohistochemical profile of paratesticular adenomatoid tumour is
strongly supportive of a mesothelial cell origin.
17
UI - 11119138
AU - Isotalo PA; Yazdi HM; Perkins DG; Mai KT
TI -
Immunohistochemical evidence for mesothelial origin of paratesticular
adenomatoid tumour.
SO - Histopathology 2000 Nov;37(5):476-7
18
UI - 11813251
AU - De Rienzo A; Tor M; Sterman DH; Aksoy F; Albelda SM; Testa JR
TI -
Detection of SV40 DNA sequences in malignant mesothelioma specimens from
the United States, but not from Turkey.
SO - J Cell Biochem 2002;84(3):455-9
AD - Human Genetics Program, Fox Chase Cancer Center, 7701 Burholme Avenue,
Philadelphia, PA 19111, USA.
The incidence of malignant mesothelioma (MM) shows a strong
epidemiological association with exposure to asbestos fibers. Recently,
simian virus 40 (SV40) DNA sequences have been reported in MM tumor
specimens from the United States and several European countries, and the
SV40 tumor virus has been implicated as a potential co-factor in the
etiology of this disease. However, several large studies from the US,
Finland, and Turkey did not detect SV40 sequences in MM samples. To
address this discrepancy, MM specimens from Turkey and the US were
analyzed in the same laboratory under identical conditions to detect the
presence of SV40 DNA. We detected SV40 sequences in 4 of 11 specimens
from the United States, but in none of the 9 Turkish samples examined.
These findings suggest that geographical differences exist with regard
to the involvement of SV40 in human tumors. Copyright 2001 Wiley-Liss,
Inc.
19
UI - 11847028
AU - Bard M; Debrosse D; Caliandro R; Girard P; Grunenwald D; Ruffie P
TI -
[Current insights in malignant pleural mesothelioma]
SO - Bull Cancer 2002 Jan;89(1):67-74
AD - Departement de medecine, Institut Gustave-Roussy, 39, rue
Camille-Desmoulins, 94805 Villejuif Cedex.
Faced with the rising incidence of malignant pleural mesothelioma (MPM),
the medical community is now busy to improve the care for this
pathology. Although there is still no unanimously recognized therapy for
MPM, long survival has been observed for some patients treated with
associated therapies (surgery + radiotherapy + chemotherapy). However,
the detection and the aggressive care of early stages MPM must be
justified by a demonstrated survival improvement with conservation of a
good quality of life. This article tries to summarize current insights
concerning epidemiology, diagnosis and treatment of MPM. At now, more
questions than responses exist concerning the care of this severe
prognosis disease.
20
UI - 11834661
AU - de Bree E; van Ruth S; Baas P; Rutgers EJ; van Zandwijk N; Witkamp AJ;
TI -
Zoetmulder FA
Cytoreductive surgery and intraoperative hyperthermic intrathoracic
chemotherapy in patients with malignant pleural mesothelioma or pleural
metastases of thymoma.
SO - Chest 2002 Feb;121(2):480-7
AD - Department of Surgical Oncology, The Netherlands Cancer Institute,
Amsterdam, The Netherlands.
STUDY OBJECTIVES: No established curative treatment is available for
pleural thymoma metastases and malignant pleural mesothelioma (MPM).
Recently, peritoneal malignancies have been treated by cytoreductive
surgery and intraoperative hyperthermic intracavitary perfusion
chemotherapy (HIPEC). We investigated the feasibility and safety of this
multimodality treatment in the thoracic cavity. DESIGN: Patients with
pleural thymoma metastases or early-stage MPM were enrolled in a
feasibility study. Morbidity, recurrence, and survival rates were
recorded. SETTING: The Netherlands Cancer Institute. PATIENTS: Three
patients with pleural thymoma metastases and 11 patients with pleural
mesothelioma were treated. INTERVENTIONS: Cytoreductive surgery and
intraoperative hyperthermic intrathoracic perfusion chemotherapy
(HITHOC) with cisplatin and adriamycin were performed. The mesothelioma
patients received adjuvant radiotherapy on the thoracotomy wound and
drainage tracts. MEASUREMENTS AND RESULTS: Morbidity and mortality rates
were 47% and 0%, respectively. Reoperation was necessary in four cases.
Severe chemotherapy-related complications were not observed. A solitary
mediastinal and a contralateral pleural thymoma recurrence were
successfully treated by radiotherapy and a contralateral HITHOC
procedure. All thymoma patients were alive and free of disease after a
mean follow-up period of 18 months. After a mean follow-up period of 7.4
months, nine mesothelioma patients are alive. Two mesothelioma patients
died of contralateral pleural and peritoneal recurrent disease, while
one patient is alive with locoregional recurrence. CONCLUSIONS:
Cytoreductive surgery and HITHOC with cisplatin and adriamycin is
feasible in patients with pleural thymoma metastases and early-stage
MPM, and is associated with acceptable morbidity rates. Early data on
locoregional disease control are encouraging, and a phase II study will
be conducted.
21
UI - 11845101
AU - Desoubeaux N; Bouvier V; Gervais R; Galateau-Salle F; Thibon P; Leplumey
TI -
T; Herbert C; Lecherbonnier Y; Daviet JP; Letourneux M
[Malignant mesothelioma in Basse-Normandie, a French population study.
Descriptive analysis, prognostic factors and survival]
SO - Rev Epidemiol Sante Publique 2001 Dec;49(6):523-9
AD - Federation des Registres de Basse-Normandie, Avenue Cote de Nacre, CHU
Caen, 14032 Caen Cedex, France.
BACKGROUND: Malignant mesothelioma is a pleural and/or peritoneal tumor
closely related to asbestos exposure, and its incidence should continue
to increase during the first two decades of the 21(rst)century. The main
prognostic factors described for this tumor are older age, sex, tumor
stage and histological type. The aim of this study was to assess the
incidence of pleural and peritoneal malignant mesothelioma in the County
of Basse-Normandie (France), as well as their epidemiological
characteristics, and the prognostic factors related to survival
duration. METHODS: Cases were identified through repeated inquiries
among all chest physicians and pathologists of the County of
Basse-Normandie. A special care was taken in the validation of the
diagnosis of each case. Incidence of mesothelioma was determined
according to sex and age (5 years categories). Qualitative and
quantitative variables were compared with the use of chi-square or
Student's t tests respectively. Survival rate was calculated by
Kaplan-Meier method, and prognostic factors were studied by means of Cox
model. RESULTS: Study population consisted in all 80 malignant
mesothelioma cases diagnosed in Basse-Normandie between the 1(rst) of
pleural mesothelioma were 1.1/100 000 in men and 0.23/100 000 in women;
annual incidence rates for peritoneal mesothelioma were 0.21/100 000 in
men and 0.13/100 000 in women. Asbestos exposure was present in 63 cases
(78.8%). The study of geographic distribution of mesothelioma cases
revealed the influence of the main asbestos industrial settings, as well
as the numerous scattered cases related to other occupational exposure.
Mean survival duration was 9 months for pleural mesothelioma and 5
months for peritoneal mesothelioma. After adjustment on age, death risk
was higher in asbestos-exposed than in non asbestos-exposed cases.
CONCLUSION: This study confirms that malignant mesothelioma is closely
related to asbestos exposure, but not only in main asbestos industrial
settings. It suggests that asbestos exposure may take place among
prognostic factors of this tumor.
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