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Vol. 40. Issue 5.
Pages 203-208 (May 2004)
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Vol. 40. Issue 5.
Pages 203-208 (May 2004)
Original Articles
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Pleural Mesothelioma: Experience With 62 Cases in 9 Years
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V. Villena Garridoa,
Corresponding author
mvg01m@saludlia.com

Correspondence: Dra. V. Villena. Servicio de Neumología. Hospital 12 de Octubre. Avda. de Córdoba, s/n. 28041 Madrid. España
, A. López Encuentraa, J. Echave-Sustaetaa, C. Álvarez Martíneza, L. Rey Terróna, M.T. Sotelob, C. Ballestínb
a Servicio de Neumología, Hospital Universitario 12 de Octubre, Universidad Complutense, Madrid, Spain
b Servicio de Anatomía Patológica, Hospital Universitario 12 de Octubre, Universidad Complutense, Madrid, Spain
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Objectives

TO describe the diagnostic approach, clinical and radiological characteristics, and survival of patients with pleural mesothelioma treated in our hospital over a 9-year period.

Patients and method

All patients with a diagnosis of pleural mesothelioma diagnosed in our hospital from January 1992 through December 2000 were studied.

Results

Sixty-two patients (49 men) with a mean age of 65 years (range, 45–85) were diagnosed. Probable or known contact with asbestos was established for 41 patients (66%). Ninety-four percent of the patients had chest pain or dyspnea at the onset of clinical assessment. The tumor was situated in the right hemithorax in 33 patients; 59 patients had pleural effusion, and 3 only had pleural thickening. The pleural fluid was bloody in 19% of patients, glucose levels were less than 60 mg/dL in 44%, and the pH of pleural fluid was less than 7.20 in 19%. The diagnosis was established by pleural biopsy for 52%, and by thoracoscopy or thoracotomy for 44%. The median survival was 11 months (95% confidence interval, 8–15); the probability of survival was 0.22 after 2 years, and 0.09 after 5. For the subgroup of patients with epithelial tumors the probability of survival was 0.31 after 2 years and 0.16 after 5 years. In the univariate analysis the predictors of survival were general clinical status (Karnofsky scale), platelet count, serum albumin level, pleural pH, glucose and lactate dehydrogenase levels, and histological type.

Conclusions

The clinical, radiological, and biochemical characteristics of the pleural fluid from patients with pleural mesothelioma and their survival rate were described.

Key words:
Mesothelioma
Malignant pleural effusion
Pleural biopsy
Survival
Objetivo

Describir las características clínicas, radiológicas, el método diagnóstico y la evolución de los pacientes con mesotelioma pleural estudiados en nuestro hospital durante 9 años.

Pacientes y Método

Se ha incluido a todos los pacientes diagnosticados de mesotelioma pleural en nuestro hospital entre enero de 1992 y diciembre de 2000.

Resultados

Se ha incluido a 62 pacientes (49 varones), con una edad media de 65 años (rango: 45–85). De ellos, 41 (66%) tenían antecedentes de contacto con asbesto seguro o probable. El 94% presentaba dolor torácico o disnea al comenzar el estudio; el tumor era derecho en 33 pacientes, en 59 había derrame pleural y en 3 sólo engrosamiento pleural. El líquido pleural era hemático en el 19% de los pacientes. El 44% tenía concentraciones de glucosa inferiores a 60 mg/dl, y en el 19% el pH pleural era inferior a 7,20. El diagnóstico se realizó en el 52% de los pacientes mediante biop-sia pleural, y en el 44% mediante toracoscopia o toracotomía. La mediana de supervivencia fue de 11 meses (intervalo de confianza del 95%, 8–15); la probabilidad de supervivencia fue de 0,22 a los 2 años, y del 0,09 a los 5 años. Para los tumores epiteliales la probabilidad de supervivencia era de 0,31 a los 2 años y de 0,16 a los 5 años. En el análisis univariante se asociaron al pronóstico de supervivencia el estado clínico general (escala de Karnofsky), el número de plaquetas, la albúmina sérica, así como el pH, la glucosa y la lactatodeshidrogenasa pleurales y el tipo histológico.

Conclusions

Se describen las características clínicas, radiológicas, del líquido pleural y la supervivencia de los pacientes con mesotelioma pleural.

Palabras clave:
Mesotelioma
Derrame pleural maligno
Biopsia pleural
Supervivencia
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