Diffuse Malignant Pleural Mesothelioma: A Multi-Institutional Clinicopathological Study
Diffuse Malignant Pleural Mesothelioma: A Multi-Institutional Clinicopathological Study
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DOI：
10.1007/s00595-008-3776-9
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发表时间：
2008-11-01
期刊：
影响因子：
2.5
通讯作者：
Yoshino, Ichiro
中科院分区：
文献类型：
--
作者：
Iyoda, Akira;Yusa, Toshikazu;Yoshino, Ichiro
目的.恶性胸膜间皮瘤（MPM）在日本相对罕见，因此很难在一个研究所对这种肿瘤进行大规模的临床病理研究。因此，我们进行了一项多机构研究，以评估日本的诊断和治疗现状。我们分析了来自日本千叶多中心研究组的13个机构的65例MPM患者的记录。在56例患者中，肿瘤是在因胸痛、呼吸急促和咳嗽等主观症状就诊后检测到的。从初次就诊到确诊的中位时间为2个月。确诊后1、2、3年生存率分别为40.5%、10.8%、0%，手术组分别为67.9%、35.0%、10.9%（P = 0.0035）。多因素分析显示，组织学类型、国际间皮瘤兴趣组临床分期、性别、临床表现为气促是影响患者预后的重要因素。早期MPM的明确诊断是困难的，但建立最佳的诊断模式将提高生存率，因为根治性手术可能是有效的可切除的疾病。
Purpose. The relative rarity of malignant pleural mesothelioma (MPM) in Japan makes it difficult to perform a large-scale clinicopathological study of this tumor at a single institute. Thus, we performed a multiinstitutional study to evaluate the current status of diagnosis and treatment in Japan.Methods. We analyzed the records of 65 patients with MPM, obtained from the 13 institutions comprising the Japanese Chiba Multicenter Study Group.Results. In 56 patients, the tumor was detected after a visit to a medical facility for subjective symptoms such as chest pain, shortness of breath, and cough. It took a median period of 2 months from the initial visit to establish the diagnosis. The overall survival rates of 33 patients with unresectable MPM 1, 2, and 3 years after the diagnosis were 40.5%, 10.8%, and 0%, respectively, whereas those of 32 patients who underwent surgery were 67.9%, 35.0% and 10.9%, respectively (P = 0.0035). According to multivariate analysis, histological type, International Mesothelioma Interest Group clinical stage, sex, and the presenting symptom of shortness of breath were significant prognostic factors.Conclusions. The definitive diagnosis of early MPM is difficult, but establishing the best diagnostic modality would improve survival rates, since radical surgery is likely to be effective for resectable disease.