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1. Terra RM, Teixeira LR, Beyruti R, Takagaki TY, Vargas FS, Jatene FB: [Malignant pleural mesothelioma: multidisciplinary experience in a public tertiary hospital]. J Bras Pneumol; 2008 Jan;34(1):13-20
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  • [Title] [Malignant pleural mesothelioma: multidisciplinary experience in a public tertiary hospital].
  • [Transliterated title] Mesotelioma pleural maligno: experiência multidisciplinar em hospital público terciário.
  • OBJECTIVE: To evaluate the experience in diagnosing and treating malignant pleural mesothelioma (MPM) accumulated over 5 years in a tertiary public hospital.
  • The biopsy specimens for histopathological examination were obtained through thoracoscopy in 9 patients (53%), Cope needle in 5 (29.5%), and open pleural biopsy in 3 (17.5%).
  • The following histological types were identified: epithelial, in 14 patients (82%); sarcomatoid, in 1 (6%); and biphasic, in 2 (12%).
  • The therapeutic approaches used were as follows: multimodal (pleuropneumonectomy and adjuvant radiotherapy and chemotherapy) in 6 patients (35%); chemotherapy and radiotherapy in 6 (35%); radiotherapy alone in 3 (17.5%); and chemotherapy alone in 2 (12%).
  • CONCLUSIONS: In the cases studied, an integrated multidisciplinary approach was used, and a highly complex hospital infrastructure was available for the diagnosis and treatment of MPM, as recommended in the literature.
  • [MeSH-major] Mesothelioma / pathology. Pleura / pathology. Pleural Neoplasms / pathology
  • [MeSH-minor] Adolescent. Adult. Aged. Biopsy. Brazil / epidemiology. Chemotherapy, Adjuvant. Delivery of Health Care, Integrated. Female. Hospitals, Public. Humans. Male. Middle Aged. Patient Care Team. Pneumonectomy / methods. Radiotherapy, Adjuvant. Retrospective Studies. Survival Analysis

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  • (PMID = 18278371.001).
  • [ISSN] 1806-3756
  • [Journal-full-title] Jornal brasileiro de pneumologia : publicaça̋o oficial da Sociedade Brasileira de Pneumologia e Tisilogia
  • [ISO-abbreviation] J Bras Pneumol
  • [Language] por
  • [Publication-type] English Abstract; Evaluation Studies; Journal Article
  • [Publication-country] Brazil
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2. Tanzi S, Tiseo M, Internullo E, Cacciani G, Capra R, Carbognani P, Rusca M, Rindi G, Ardizzoni A: Localized malignant pleural mesothelioma: report of two cases. J Thorac Oncol; 2009 Aug;4(8):1038-40
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  • [Title] Localized malignant pleural mesothelioma: report of two cases.
  • Localized malignant pleural mesothelioma is very rare tumor disease.
  • There are sporadic reports in the literature showing that this entity has a different biologic behavior compared with diffuse pleural mesothelioma.
  • We report two cases of radically resected localized pleural malignant mesothelioma, with a previous history of asbestos exposure.
  • Both cases showed a microscopic and immunohistochemical findings of malignant mesothelioma, biphasic and sarcomatoid lympho-histiocitoid variant type, respectively, without evidence of diffuse pleural spread.
  • The first is very peculiar case of bilateral localized malignant pleural mesothelioma with complete response to chemotherapy and localized late recurrence, radically resected and treated with adjuvant radiotherapy.
  • Both cases demonstrate that the localized malignant mesothelioma should be distinguished from diffuse form and that complete resection is associated with good prognosis.
  • [MeSH-major] Neoplasm Recurrence, Local / pathology. Pleural Neoplasms / pathology. Solitary Fibrous Tumor, Pleural / pathology

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  • (PMID = 19633479.001).
  • [ISSN] 1556-1380
  • [Journal-full-title] Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
  • [ISO-abbreviation] J Thorac Oncol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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3. Greillier L, Cavailles A, Fraticelli A, Scherpereel A, Barlesi F, Tassi G, Thomas P, Astoul P: Accuracy of pleural biopsy using thoracoscopy for the diagnosis of histologic subtype in patients with malignant pleural mesothelioma. Cancer; 2007 Nov 15;110(10):2248-52
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  • [Title] Accuracy of pleural biopsy using thoracoscopy for the diagnosis of histologic subtype in patients with malignant pleural mesothelioma.
  • BACKGROUND: Promising results with trimodality therapy combining surgery, chemotherapy, and radiotherapy have been obtained in the management of patients with malignant pleural mesothelioma (MPM).
  • The aim of the current study was to analyze retrospectively the accuracy, sensitivity, and specificity of preoperative thoracoscopy for diagnosis of the histologic subtype of MPM.
  • METHODS: The histologic reports from all consecutive patients undergoing 'intent-to-treat' surgery from 3 institutions as well as the initial pathologic diagnosis obtained using thoracoscopy were reviewed and compared after institutional review board approval.
  • Of the 95 patients with a final diagnosis of MPM, 80 (84.2%) were classified as having epithelial and 15 (15.8%) as having biphasic subtype.
  • Among the 87 patients classified as having MPM of epithelial subtype after the initial thoracoscopy, 75 cases (86.2%) were confirmed to be a true histologic diagnosis and 12 cases (13.8%) were found to be of biphasic subtype at final diagnosis.
  • One patient with a biphasic subtype at initial thoracoscopy was found to have MPM of epithelial subtype after surgery.
  • The sensitivity and specificity values of an epithelial subtype diagnosis after thoracoscopy were 94% and 20%, respectively, with a positive predictive value of 86% and a negative predictive value of 37%.
  • Conversely, the sensitivity and specificity values of a biphasic subtype diagnosis after thoracoscopy were 20% and 98%, respectively, with a positive predictive value of 75% and a negative predictive value of 87%.
  • CONCLUSIONS: Pleural biopsy performed using thoracoscopy is considered to be the cornerstone of the diagnosis and pleural staging of MPM.
  • However, this procedure appears to be less efficient in diagnosing the histologic subtype as either epithelial or biphasic.
  • [MeSH-major] Biopsy / methods. Mesothelioma / pathology. Pleural Neoplasms / pathology. Thoracoscopy / methods

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  • [Copyright] (c) 2007 American Cancer Society.
  • (PMID = 17886249.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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4. Jänne PA, Taffaro ML, Salgia R, Johnson BE: Inhibition of epidermal growth factor receptor signaling in malignant pleural mesothelioma. Cancer Res; 2002 Sep 15;62(18):5242-7
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  • [Title] Inhibition of epidermal growth factor receptor signaling in malignant pleural mesothelioma.
  • Malignant pleural mesothelioma (MPM) is a rare malignancy with no known curative modality.
  • We have determined the effects of EGFR inhibition in MPM cell lines in vitro, using four MPM cell lines derived from previously untreated patients with epithelial (H2461 and H2591), sarcomatoid (H2373), and biphasic (MSTO-211H) MPM.
  • Furthermore, treatment with ZD1839 led to a significant dose-dependent reduction of colony formation (41-89% at 10 microM) when MPM cells were grown in soft agarose.
  • Our findings demonstrate that in vitro, ZD1839 is as effective or more effective against MPM cell lines as it is against the NSCLC cell line A549 and suggest that ZD1839 may be an effective therapeutic option for patients with MPM.
  • [MeSH-major] Antineoplastic Agents / pharmacology. Mesothelioma / drug therapy. Pleural Neoplasms / drug therapy. Quinazolines / pharmacology. Receptor, Epidermal Growth Factor / antagonists & inhibitors
  • [MeSH-minor] Carcinoma, Non-Small-Cell Lung / drug therapy. Carcinoma, Non-Small-Cell Lung / metabolism. Carcinoma, Non-Small-Cell Lung / pathology. Cell Cycle / drug effects. Cell Division / drug effects. Epidermal Growth Factor / pharmacology. Humans. Lung Neoplasms / drug therapy. Lung Neoplasms / metabolism. Lung Neoplasms / pathology. Phosphorylation. Signal Transduction / drug effects. Signal Transduction / physiology. Tumor Cells, Cultured

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  • (PMID = 12234991.001).
  • [ISSN] 0008-5472
  • [Journal-full-title] Cancer research
  • [ISO-abbreviation] Cancer Res.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Quinazolines; 62229-50-9 / Epidermal Growth Factor; EC 2.7.10.1 / Receptor, Epidermal Growth Factor; S65743JHBS / gefitinib
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5. Adusumilli PS, Chan MK, Chun YS, Hezel M, Chou TC, Rusch VW, Fong Y: Cisplatin-induced GADD34 upregulation potentiates oncolytic viral therapy in the treatment of malignant pleural mesothelioma. Cancer Biol Ther; 2006 Jan;5(1):48-53
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  • [Title] Cisplatin-induced GADD34 upregulation potentiates oncolytic viral therapy in the treatment of malignant pleural mesothelioma.
  • BACKGROUND: NV1066, a replication-competent oncolytic herpes simplex virus type 1 (HSV-1) attenuated by a deletion in the gene gamma(1)34.5, preferentially replicates in and kills malignant cells. gamma(1)34.5 encodes ICP34.5, a viral protein essential for productive replication, which has homology with mammalian stress response induced GADD34 (growth arrest and DNA damage-inducible protein).
  • METHODS: Ten human malignant pleural mesothelioma (MPM) cell lines were infected with NV1066 at multiplicities of infection (MOI; ratio of viral particles per tumor cell) 0.005 to 0.8 in vitro, with and without cisplatin (1 to 4 microM).
  • RESULTS: Combination therapy with NV1066 and cisplatin showed strong synergism in epithelioid (H-2452, H-Meso), sarcomatoid (H-2373, H-28), and biphasic (JMN, Meso-9, MSTO-211H) MPM cell lines, and an additive effect in others.
  • In VAMT cells combination therapy enhanced viral replication 4 to 11-fold (p < 0.01) and cell kill 2 to 3-fold (p < 0.01).
  • Significant dose reductions for both agents (2 to 600-fold) were achieved over a wide range of therapeutic-effect levels (LD50-LD99) without compromising cell kill.
  • This provides a cellular basis for combination therapy with cisplatin and NV1066 to treat MPM and achieve synergistic efficacy, while minimizing dosage and toxicity.

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  • (PMID = 16294031.001).
  • [ISSN] 1538-4047
  • [Journal-full-title] Cancer biology & therapy
  • [ISO-abbreviation] Cancer Biol. Ther.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / R01 CA075416; United States / NCI NIH HHS / CA / R01 CA080982; United States / NCI NIH HHS / CA / R01 CA 76416; United States / NCI NIH HHS / CA / R01 CA/DK80982
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antigens, Differentiation; 0 / Cell Cycle Proteins; 0 / RNA, Small Interfering; 0 / Viral Proteins; EC 3.1.3.16 / PPP1R15A protein, human; EC 3.1.3.16 / Protein Phosphatase 1; Q20Q21Q62J / Cisplatin
  • [Other-IDs] NLM/ NIHMS7204; NLM/ PMC1383726
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6. Yanagihara K, Tsumuraya M, Takigahira M, Mihara K, Kubo T, Ohuchi K, Seyama T: An orthotopic implantation mouse model of human malignant pleural mesothelioma for in vivo photon counting analysis and evaluation of the effect of S-1 therapy. Int J Cancer; 2010 Jun 15;126(12):2835-46
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  • [Title] An orthotopic implantation mouse model of human malignant pleural mesothelioma for in vivo photon counting analysis and evaluation of the effect of S-1 therapy.
  • Human malignant pleural mesothelioma (HMPM) is an aggressive neoplasm that is highly resistant to conventional therapies.
  • We established 3 HMPM cell lines (TCC-MESO-1, TCC-MESO-2 and TCC-MESO-3) from Japanese patients; the first 2 from the primary and metastatic tumors of a patient with the epithelioid type of HMPM, and the third from a patient with biphasic characteristics of the tumor (epithelioid and sarcomatous phenotypes).
  • Oral administration of S-1, an anticancer agent, suppressed the proliferation of the luciferase gene-expressing Me1Tu subline in the mouse models in vivo, with a treated-to-control ratio of the mean tumor volume of 0.2.
  • The orthotopic implantation mouse model proved to be useful for quantitative evaluation of the efficacy of novel anticancer drugs and also for studying the biology of HMPMs in vivo.
  • [MeSH-major] Antimetabolites, Antineoplastic / administration & dosage. Disease Models, Animal. Mesothelioma / drug therapy. Oxonic Acid / administration & dosage. Photons. Pleural Neoplasms / drug therapy. Tegafur / administration & dosage
  • [MeSH-minor] Administration, Oral. Animals. Cell Line, Transformed. Cell Proliferation / drug effects. Cell Survival. Cytokines / metabolism. Drug Combinations. Humans. Immunoenzyme Techniques. Luciferases / metabolism. Male. Mice. Mice, Inbred BALB C. Mice, Nude. Mice, SCID. Middle Aged. Neoplasm Proteins / metabolism. Tumor Cells, Cultured. Tumor Suppressor Protein p53 / genetics. Xenograft Model Antitumor Assays


7. Motta AB, Pinheiro G, Antonângelo L, Parra ER, Monteiro MM, Pereira JC, Takagaki T, Terra Filho M, Martins S, Capelozzi VL: Morphological aspects as prognostic factors in malignant mesothelioma: a study of 58 cases. J Bras Pneumol; 2006 Jul-Aug;32(4):322-32
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  • [Title] Morphological aspects as prognostic factors in malignant mesothelioma: a study of 58 cases.
  • OBJECTIVE: Various markers have shown promise as diagnostic markers and prognostic predictors in malignant mesothelioma (MM).
  • METHODS: Through morphometric and immunological studies of markers in stromal components (calretinin, CEA, Leu-M1 and thrombomodulin) and nuclear components (p53 and Ki-67), we evaluated post-diagnosis survival in 58 patients with MM.
  • Through immunohistochemistry, we confirmed 40 cases of mesothelioma and 11 cases of adenocarcinoma, although we were unable to classify 7 of the 8 cases presenting atypical histologic patterns.
  • Cox multivariate analysis revealed that the risk factor for death was higher (476.2) among patients of advanced age, presenting the biphasic subtype and testing positive for components expressed at the nuclear level.
  • CONCLUSION: The most useful immunohistochemical markers were was calretinin (for mesothelioma) and CEA (for adenocarcinoma).
  • Immunohistochemical quantification of thrombomodulin facilitated the diagnosis of mesothelioma in patients testing positive for both calretinin and CEA.
  • The most useful prognostic information was that provided by the routine histopathological analysis of the tumor type.
  • Therefore, histopathological analysis offers a powerful weapon with great potential to inform decisions regarding the use of adjuvant chemotherapy after surgical excision of a mesothelioma.
  • [MeSH-major] Adenocarcinoma / diagnosis. Biomarkers, Tumor / analysis. Mesothelioma / diagnosis. Pleural Neoplasms / diagnosis

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  • (PMID = 17268732.001).
  • [ISSN] 1806-3756
  • [Journal-full-title] Jornal brasileiro de pneumologia : publicaça̋o oficial da Sociedade Brasileira de Pneumologia e Tisilogia
  • [ISO-abbreviation] J Bras Pneumol
  • [Language] eng; por
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Brazil
  • [Chemical-registry-number] 0 / Antigens, CD15; 0 / Antigens, Neoplasm; 0 / Biomarkers, Tumor; 0 / CALB2 protein, human; 0 / Calbindin 2; 0 / Carcinoembryonic Antigen; 0 / Ki-67 Antigen; 0 / Leu-M1 antigen; 0 / S100 Calcium Binding Protein G; 0 / Thrombomodulin; 0 / Tumor Suppressor Protein p53
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8. Kawamata O, Uda M, Mori M, Urakubo N, Hamano R, Oota T: [Gemcitabine improved QOL and survival in a case of diffuse malignant pleural mesothelioma]. Gan To Kagaku Ryoho; 2003 Apr;30(4):551-4
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  • [Title] [Gemcitabine improved QOL and survival in a case of diffuse malignant pleural mesothelioma].
  • Diffuse malignant pleural mesothelioma is a disease with poor prognosis, and no standard therapy for inoperable cases has been established.
  • There are several reported trials using various anticancer drugs, but their sample sizes were small and none documented the drugs' effectiveness.
  • Recently, some reports revealed that gemcitabine (GEM), which has been demonstrated to be effective for the treatment of non-small cell lung carcinoma, was effective in cases of diffuse malignant pleural mesothelioma.
  • We also treated a 76-year-old female patient with inoperable, biphasic malignant pleural mesothelioma in whom monotherapy with GEM 1,000 mg/m2 was continued leading to improved QOL and survival for 2 years.
  • It is suggested that GEM is a potentially effective drug for the improvement of QOL in inoperable cases of diffuse malignant pleural mesothelioma.
  • [MeSH-major] Antimetabolites, Antineoplastic / administration & dosage. Deoxycytidine / administration & dosage. Deoxycytidine / analogs & derivatives. Mesothelioma / drug therapy. Pleural Neoplasms / drug therapy. Quality of Life
  • [MeSH-minor] Aged. Drug Administration Schedule. Female. Humans. Prognosis. Survivors

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  • (PMID = 12722691.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 0W860991D6 / Deoxycytidine; B76N6SBZ8R / gemcitabine
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9. Ehlers EM, Kühnel W, Wiedemann GJ: Hyperthermia and mafosfamide in a human-derived malignant pleural mesothelioma cell line. J Cancer Res Clin Oncol; 2002 Feb;128(2):65-72
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  • [Title] Hyperthermia and mafosfamide in a human-derived malignant pleural mesothelioma cell line.
  • PURPOSE: Diffuse malignant pleural mesothelioma is the most common primary pleural malignancy.
  • Meanwhile, the use of asbestos has led to and is still leading to a rise in pleural mesothelioma incidence.
  • There is no standard therapy for this highly aggressive disease and the development of new therapeutic strategies is imperative.
  • METHODS: We, therefore, investigated the morphological and pharmakokinetic effects of a combined thermochemotherapy consisting of the administration of different dosages of mafosfamide with and without the application of a 1-h hyperthermia at 41.7 degrees C on the human biphasic malignant pleural mesothelioma cell line MSTO-211H.
  • After therapy, cells were prepared for light and electron microscopy.
  • BrdU-incorporation for the S-phase fraction, TUNEL-labeling for detection of apoptosis, and quantitative assessments using the MTT assay were performed.
  • During combined thermochemotherapy, cell damage and death is already induced at lower mafosfamide concentrations than without hyperthermia which suggests an additive effect from hyperthermia to the action of the alkylating drug mafosfamide.
  • CONCLUSIONS: We suggest that the effect of substances such as ifosfamide and cyclophosfamide which are in clinical use, might be enhanced by the combination of local or regional hyperthermia in order to improve the therapeutical index of these substances in the treatment of pleural mesothelioma.
  • [MeSH-major] Antineoplastic Agents / pharmacokinetics. Antineoplastic Agents / pharmacology. Apoptosis. Cyclophosphamide / analogs & derivatives. Cyclophosphamide / pharmacokinetics. Cyclophosphamide / pharmacology. Hyperthermia, Induced. Mesothelioma / pathology. Pleural Neoplasms / pathology
  • [MeSH-minor] Cell Cycle. Combined Modality Therapy. DNA Damage. Flow Cytometry. Humans. Microscopy, Electron. Temperature. Tumor Cells, Cultured

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  • (PMID = 11862475.001).
  • [ISSN] 0171-5216
  • [Journal-full-title] Journal of cancer research and clinical oncology
  • [ISO-abbreviation] J. Cancer Res. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 5970HH9923 / mafosfamide; 8N3DW7272P / Cyclophosphamide
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10. Caliandro R, Terrier P, Regnard JF, De Montpréville V, Ruffié P: [Primary biphasic synovial sarcoma of the pleura]. Rev Mal Respir; 2000 Apr;17(2):498-502
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  • [Title] [Primary biphasic synovial sarcoma of the pleura].
  • A 36-year-old man presented with a pleural tumor.
  • The first pathologic analysis diagnosed biphasic pleural malignant mesothelioma.
  • However, the atypical clinical course, the early development of lung metastases and a new reading of histologic documents led to the diagnosis of primary pleural synovial sarcoma.
  • Only a complete immuno-histochemical study confronted with the clinical course can lead to the correct diagnosis.
  • Because the efficacy of chemotherapy and/or radiotherapy is poor, surgery remains the basis of treatment, whenever possible.
  • [MeSH-major] Pleural Neoplasms / pathology. Sarcoma, Synovial / pathology
  • [MeSH-minor] Adult. Diagnosis, Differential. Humans. Immunohistochemistry. Lung Neoplasms / secondary. Male. Mesothelioma / pathology. Neoplasm Recurrence, Local / pathology. Prognosis. Survival Rate. Treatment Outcome

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  • (PMID = 10859770.001).
  • [ISSN] 0761-8425
  • [Journal-full-title] Revue des maladies respiratoires
  • [ISO-abbreviation] Rev Mal Respir
  • [Language] fre
  • [Publication-type] Case Reports; English Abstract; Journal Article; Review
  • [Publication-country] FRANCE
  • [Number-of-references] 14
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11. Kawamata O, Kondu Y, Murata T, Uetsuka H, Uda M, Nakai H, Ohta T: [Malignant pleural mesothelioma]. Kyobu Geka; 2007 Jan;60(1):31-4
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  • [Title] [Malignant pleural mesothelioma].
  • Malignant pleural mesothelioma carries a poor prognosis, for which no standard therapy has been established.
  • We report 15 cases of malignant pleural mesothelioma experienced since 2000 focusing on their clinical features.
  • All patients were diagnosed by pleural biopsy under thoracoscopic guidance.
  • Histology of the pleural biopsy specimen showed epithelial mesothelioma in 8 patients, biphasic mesothelioma in 3, sarcomatous mesothelioma in 2 and desmoplastic malignant mesothelioma (DMM) in 2.
  • Twelve patients received chemotherapy.
  • In addition to 2 of these 3 patients, 2 underwent extrapleural pneumonectomy (EPP) without adjuvant treatment.
  • Remaining 1 received palliative treatment only.
  • The longest survival time with chemotherapy is 41 months in a surviving patient with epithelial mesothelioma and that with EPP is 25 months in a surviving patient with DMM.
  • The 2-year survival rate of the 14 patients was 44.4% and the median survival time in patients with epithelial mesothelioma was 30.6 months.
  • [MeSH-major] Mesothelioma / therapy. Pleural Neoplasms / therapy

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  • (PMID = 17249535.001).
  • [ISSN] 0021-5252
  • [Journal-full-title] Kyobu geka. The Japanese journal of thoracic surgery
  • [ISO-abbreviation] Kyobu Geka
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Japan
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12. Katsuragi N, Shiraishi Y, Kita H, Toishi M, Miyasaka Y, Tanaka S: [Diffuse malignant pleural mesothelioma]. Kyobu Geka; 2007 Jan;60(1):35-9
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  • [Title] [Diffuse malignant pleural mesothelioma].
  • Malignant pleural mesothelioma is an uncommon neoplasm that caused 647 deaths in Japan in 2004.
  • We reviewed the clinical features in 11 consecutive patients with pathologically confirmed diffuse malignant pleural mesothelioma in our institution from January 1997 to December 2002.
  • A definitive diagnosis was made by closed pleural biopsy in 8 patients, pleural fluid cytology in 2, and autopsy in 1.
  • Histological subtypes included epithelioid in 6 patients, sarcomatoid in 2, biphasic in 1, and unknown in 2.
  • International Mesothelioma Interest Group (IMIG) staging included stage II in 6 patients, stage III in 3, and stage IV in 2.
  • Median period between presentation and diagnosis was 1 (range, 0 to 22) month.
  • Treatment included intrapleural chemotherapy in 4 patients, extrapleural pneumonectomy in 3, pleural drainage in 2, and best supportive care in 2.
  • Median survival time after diagnosis was 3 (range, 0 to 51) months.
  • Of the 11 patients, 7 (64%) died within 6 months after the first presentation, and only 1 (9%) lived longer than 2 years after diagnosis.
  • [MeSH-major] Mesothelioma. Pleural Neoplasms

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  • (PMID = 17249536.001).
  • [ISSN] 0021-5252
  • [Journal-full-title] Kyobu geka. The Japanese journal of thoracic surgery
  • [ISO-abbreviation] Kyobu Geka
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
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13. Uramoto H, Shimokawa H, Baba T, Shigematsu Y, Nagata Y, Ono K, Takenoyama M, Hanagiri T: [Experience in treating patients with malignant pleural mesothelioma]. J UOEH; 2010 Sep 1;32(3):257-64
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Experience in treating patients with malignant pleural mesothelioma].
  • The objective of this study was to analyze the outcome of patients with malignant pleural mesothelioma who were treated from 1993 to 2009.
  • We analyzed a total of 28 patients with malignant pleural mesothelioma.
  • Twelve and 16 of the patients underwent an extrapleural pneumonectomy and a pleural biopsy, respectively.
  • The histological types included 14 epithelial type, 8 biphasic type, and 6 sarcomatoid type.
  • Fourteen and eight of the patients underwent systemic chemotherapy and radiotherapy, respectively.
  • The 2-year survival rate of all the patients was 25.7%, and the 2-year survival of the patients with at least one more modalities of the treatments with chemotherapy, radiotherapy and extrapleural pneumonectomy were much higher than those without.
  • We should therefore consider selecting a multimodality treatment for such patients because the administration of either systemic chemotherapy or radiotherapy was found to be associated with a favorable prognosis.
  • [MeSH-major] Mesothelioma / therapy. Pleural Neoplasms / therapy
  • [MeSH-minor] Aged. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Pneumonectomy. Survival Rate. Treatment Outcome

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  • (PMID = 20857819.001).
  • [ISSN] 0387-821X
  • [Journal-full-title] Journal of UOEH
  • [ISO-abbreviation] J. UOEH
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Japan
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14. Zielinski M, Hauer J, Hauer L, Pankowski J, Nabialek T, Szlubowski A: Staging algorithm for diffuse malignant pleural mesothelioma. Interact Cardiovasc Thorac Surg; 2010 Feb;10(2):185-9
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  • [Title] Staging algorithm for diffuse malignant pleural mesothelioma.
  • An algorithm of preoperative mediastinal nodal staging with endobronchial/endoesophageal ultrasonography (EBUS/EUS) and transcervical extended mediastinal lymphadenectomy (TEMLA) combined with laparoscopy/peritoneal lavage and cytology was analyzed to establish the realistic criteria for radical multimodality treatment of malignant pleural mesothelioma (MPM).
  • The algorithm included computed tomography (CT), thoracoscopy with multiple pleural biopsies and talc pleurodesis, EBUS/EUS and one-stage TEMLA and laparoscopy/peritoneal lavage and cytology of the fluid.
  • There were 16 women and 26 men in ages ranging from 43 to 77 years (mean 57.8); 31 epithelioid, 2 sarcomatoid and 9 biphasic type MPM.
  • 21/42 patients were considered possible candidates for multimodality treatment.
  • Three patients who received neoadjuvant chemotherapy were excluded from this study.
  • [MeSH-major] Algorithms. Mesothelioma / diagnosis. Neoplasm Staging / methods. Pleural Neoplasms / diagnosis
  • [MeSH-minor] Adult. Aged. Biopsy. Chemotherapy, Adjuvant. Endosonography. Female. Humans. Laparoscopy. Lymph Node Excision. Lymphatic Metastasis. Male. Medical Futility. Middle Aged. Patient Selection. Peritoneal Lavage. Pleurodesis. Predictive Value of Tests. Radiotherapy, Adjuvant. Thoracoscopy. Tomography, X-Ray Computed. Treatment Outcome

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  • (PMID = 19843550.001).
  • [ISSN] 1569-9285
  • [Journal-full-title] Interactive cardiovascular and thoracic surgery
  • [ISO-abbreviation] Interact Cardiovasc Thorac Surg
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] England
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15. Okubo K, Sonobe M, Fujinaga T, Shoji T, Sakai H, Miyahara R, Bando T, Date H, Shibuya K, Hiraoka M: Survival and relapse pattern after trimodality therapy for malignant pleural mesothelioma. Gen Thorac Cardiovasc Surg; 2009 Nov;57(11):585-90
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  • [Title] Survival and relapse pattern after trimodality therapy for malignant pleural mesothelioma.
  • PURPOSE: Multimodality therapy has been applied to resectable malignant pleural mesothelioma, but the tolerability of the treatment and relapse pattern in detail remain unknown.
  • We reviewed our experience of trimodality therapy as a single-institution study in Japan.
  • METHODS: A total of 16 patients with resectable malignant pleural mesothelioma were intended to treat with extra-pleural pneumonectomy followed by platinum-based chemotherapy and external beam radiation therapy.
  • The histology of the tumors was epithelioid in 10, sarcomatoid in 4, and biphasic in 2.
  • International Mesothelioma Interest Group staging was stage II in 1, stage III in 11, and stage IV in 4.
  • The tolerability to the combined treatment, the survival, and the relapse pattern were examined.
  • In all, 14 patients received chemotherapy, and subsequently 13 underwent radiotherapy, indicating a tolerability of 81%.
  • CONCLUSION: Trimodality therapy showed a survival benefit in patients with stage III or lower malignant pleural mesothelioma.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Neoplasm Recurrence, Local. Neoplasms, Mesothelial / therapy. Pleural Neoplasms / therapy. Pneumonectomy
  • [MeSH-minor] Aged. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Female. Humans. Japan. Kaplan-Meier Estimate. Male. Middle Aged. Neoplasm Staging. Prospective Studies. Radiation Dosage. Radiotherapy, Adjuvant / adverse effects. Time Factors. Treatment Outcome

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  • (PMID = 19908112.001).
  • [ISSN] 1863-6713
  • [Journal-full-title] General thoracic and cardiovascular surgery
  • [ISO-abbreviation] Gen Thorac Cardiovasc Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin
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16. Dowell J, Taub R, Lan C, Xie Y, Dunphy F, Blake V, Kindler H: A multicenter phase II study of pemetrexed (P), cisplatin (C), and bevacizumab (B) in patients (pts) with advanced malignant mesothelioma (MM). J Clin Oncol; 2009 May 20;27(15_suppl):7578

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A multicenter phase II study of pemetrexed (P), cisplatin (C), and bevacizumab (B) in patients (pts) with advanced malignant mesothelioma (MM).
  • Standard chemotherapy for MM, pemetrexed + cisplatin, yields a response rate of 41%, progression-free survival (PFS) of 5.7 months (mo) and median overall survival (OS) of 12.1 mo.
  • METHODS: Eligible pts have unresectable, histologically-confirmed MM, no prior chemotherapy, and PS 0-1.
  • Pt characteristics: male 88%; median age 66 (range 24-81); histology: epithelial 62%, sarcomatoid 15%, biphasic 20%, unknown 3%; site of origin: pleural 85%, peritoneal 12%, tunica vaginalis 3%; PS 0 32%, PS 1 68%; thrombocytosis (>400) 32%.

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  • (PMID = 27963386.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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17. de Perrot M, Feld R, Cho BC, Bezjak A, Anraku M, Burkes R, Roberts H, Tsao MS, Leighl N, Keshavjee S, Johnston MR: Trimodality therapy with induction chemotherapy followed by extrapleural pneumonectomy and adjuvant high-dose hemithoracic radiation for malignant pleural mesothelioma. J Clin Oncol; 2009 Mar 20;27(9):1413-8
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  • [Title] Trimodality therapy with induction chemotherapy followed by extrapleural pneumonectomy and adjuvant high-dose hemithoracic radiation for malignant pleural mesothelioma.
  • PURPOSE: Malignant pleural mesothelioma (MPM) remains associated with poor outcome.
  • We examined the results of trimodality therapy with cisplatin-based chemotherapy followed by extrapleural pneumonectomy (EPP) and adjuvant high-dose (50 to 60 Gy) hemithoracic radiation therapy for MPM.
  • PATIENTS AND METHODS: We conducted a retrospective review of all patients prospectively evaluated for trimodality therapy protocol between January 2001 and December 2007 in our institution.
  • Histology was epithelioid (n = 44) or biphasic (n = 16).
  • Chemotherapy regimens included cisplatin/vinorelbine (n = 26), cisplatin/pemetrexed (n = 24), cisplatin/raltitrexed (n = 6), or cisplatin/gemcitabine (n = 4).
  • EPP was performed in 45 patients, and hemithoracic radiation therapy to at least 50 Gy was administered postoperatively to 30 patients.
  • Completion of the trimodality therapy in the absence of mediastinal node involvement was associated with the best survival (median survival of 59 months v <or= 14 months in the remaining patients, P = .0003).
  • The type of induction chemotherapy had no significant impact on survival.
  • Pathologic nodal status remained a significant predictor of poor survival despite completion of the trimodality therapy.
  • CONCLUSION: This large, single-center experience with induction chemotherapy followed by EPP and adjuvant high-dose hemithoracic radiation for MPM shows that half of the patients are able to complete this protocol.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Mesothelioma / therapy. Pleural Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Deoxycytidine / administration & dosage. Deoxycytidine / analogs & derivatives. Disease-Free Survival. Female. Glutamates / administration & dosage. Guanine / administration & dosage. Guanine / analogs & derivatives. Humans. Male. Middle Aged. Neoadjuvant Therapy. Pemetrexed. Pneumonectomy. Quinazolines / administration & dosage. Radiotherapy, Adjuvant. Remission Induction. Retrospective Studies. Thiophenes / administration & dosage. Vinblastine / administration & dosage. Vinblastine / analogs & derivatives

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  • (PMID = 19224855.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Glutamates; 0 / Quinazolines; 0 / Thiophenes; 04Q9AIZ7NO / Pemetrexed; 0W860991D6 / Deoxycytidine; 5V9KLZ54CY / Vinblastine; 5Z93L87A1R / Guanine; B76N6SBZ8R / gemcitabine; FCB9EGG971 / raltitrexed; Q20Q21Q62J / Cisplatin; Q6C979R91Y / vinorelbine
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18. Balduyck B, Trousse D, Nakas A, Martin-Ucar AE, Edwards J, Waller DA: Therapeutic surgery for nonepithelioid malignant pleural mesothelioma: is it really worthwhile? Ann Thorac Surg; 2010 Mar;89(3):907-11
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Therapeutic surgery for nonepithelioid malignant pleural mesothelioma: is it really worthwhile?
  • BACKGROUND: Debate remains about the relative prognostic importance of the histologic subtype of malignant pleural mesothelioma.
  • METHODS: From a prospective database, the details of 312 malignant pleural mesothelioma surgical patients were reviewed.
  • A comparison was made of the survival from the three major cell types.
  • Final histologic subtype was epithelioid in 218 patients, biphasic in 66 patients, and sarcomatoid in 28 patients.
  • The median survival was 15.3 months in the epithelioid group, 10.1 months in the biphasic group, and 5.0 months in the sarcomatoid group.
  • On univariate analysis in the epithelioid group, age (p = 0.005), International Mesothelioma Interest Group stage (p = 0.001), radicality of the procedure (p = 0.001), leukocytosis (p = 0.016), and preoperative or postoperative chemotherapy (p = 0.012) were significant prognostic factors influencing postoperative survival.
  • In the biphasic group, preoperative anemia was the only significant factor (p = 0.007).
  • In sarcomatoid patients, International Mesothelioma Interest Group stage and radicality of the surgical procedure were significant prognostic variables (p = 0.012 and p = 0.015, respectively).
  • Multivariate analysis in the epithelioid group identified International Mesothelioma Interest Group stage (p = 0.001), radicality of the procedure (p = 0.008), and preoperative or postoperative chemotherapy (p = 0.007) as significant prognostic factors, whereas in the sarcomatoid group, only the International Mesothelioma Interest Group stage (p = 0.012) was significant and the radicality of surgery had no effect.
  • CONCLUSIONS: The extremely poor prognosis of sarcomatoid malignant pleural mesothelioma is independent of the extent of surgery unlike other cell types.
  • Patients with sarcomatoid histology should therefore be considered separately in trials evaluating radical procedures and adjuvant treatment.
  • The treatment of biphasic pleural mesothelioma remains debatable.
  • [MeSH-major] Mesothelioma / surgery. Pleural Neoplasms / surgery

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  • [Copyright] 2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
  • (PMID = 20172152.001).
  • [ISSN] 1552-6259
  • [Journal-full-title] The Annals of thoracic surgery
  • [ISO-abbreviation] Ann. Thorac. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Netherlands
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19. Steele JP, Shamash J, Evans MT, Gower NH, Tischkowitz MD, Rudd RM: Phase II study of vinorelbine in patients with malignant pleural mesothelioma. J Clin Oncol; 2000 Dec 01;18(23):3912-7
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  • [Title] Phase II study of vinorelbine in patients with malignant pleural mesothelioma.
  • PURPOSE: To evaluate the response rate and impact on quality of life of vinorelbine given as cycles of 30 mg/m(2) weekly for 6 weeks to patients with malignant pleural mesothelioma.
  • PATIENTS AND METHODS: Twenty-nine patients with histologically proven malignant pleural mesothelioma were enrolled (26 male patients and three female patients; median age, 58 years [range, 29 to 77 years]).
  • Seventeen patients had epithelioid tumors, two had sarcomatoid tumors, and 10 had biphasic tumors.
  • The International Mesothelioma Interest Group staging system was used: one patient had stage Ib disease, 10 had stage II disease, eight had stage III disease, and 10 had stage IV disease.
  • The new guidelines to evaluate the response to treatment in solid tumors were used.
  • Responses were measured by spiral computed tomography scan.
  • There were seven partial responses (24% [95% confidence interval, 10% to 44%]), 16 patients had stable disease (55%), and six patients had disease progression on therapy (21%).
  • Quality-of-life analyses showed a benefit for vinorelbine therapy.
  • CONCLUSION: Vinorelbine shows promise in the palliation of patients with malignant pleural mesothelioma.
  • The relatively low toxicity of the drug suggests that trials of vinorelbine in combination with other agents should be feasible.
  • [MeSH-major] Antineoplastic Agents, Phytogenic / therapeutic use. Mesothelioma / drug therapy. Pleural Neoplasms / drug therapy. Vinblastine / analogs & derivatives. Vinblastine / therapeutic use
  • [MeSH-minor] Adult. Aged. Drug Administration Schedule. Female. Humans. Male. Middle Aged. Quality of Life. Survival Rate

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  • (PMID = 11099320.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; 5V9KLZ54CY / Vinblastine; Q6C979R91Y / vinorelbine
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20. Mineo TC, Ambrogi V, Cufari ME, Pompeo E: May cyclooxygenase-2 (COX-2), p21 and p27 expression affect prognosis and therapeutic strategy of patients with malignant pleural mesothelioma? Eur J Cardiothorac Surg; 2010 Sep;38(3):245-52
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] May cyclooxygenase-2 (COX-2), p21 and p27 expression affect prognosis and therapeutic strategy of patients with malignant pleural mesothelioma?
  • OBJECTIVES: The expression of cyclooxygenase-2 (COX-2) and cell-cycle proteins (p21 and p27) proves useful in predicting prognosis and orientating therapy in many malignant tumours.
  • Malignant pleural mesothelioma is an uncommon and lethal cancer for which there are limited treatment options.
  • In this study, we evaluated the impact on prognosis and the influence on therapeutic strategy of immunohistochemical expression of COX-2, p21 and p27 in specimens from patients treated for malignant pleural mesothelioma.
  • METHODS: We retrospectively reviewed immunohistochemical expression of COX-2, p21 and p27 dichotomised into high and low expression from specimens of 77 consecutive patients undergoing biopsy-plus-pleurodesis (n=6), pleurectomy-decortication (n=44) or extrapleural pneumonectomy (n=27) operations for malignant pleural mesothelioma between 1987 and 2007.
  • Histology was of epithelioid (n=50), biphasic (n=17) and sarcomatoid (n=10) subtypes.
  • Therapies used were sole adjuvant radiotherapy (n=17), adjuvant radio-chemotherapy (n=56) and neo-adjuvant chemotherapy plus adjuvant radiotherapy (n=4).
  • From 2005 on, preoperative maximal standard uptake value (SUV(MAX)) was also measured by fluorodeoxyglucose positron-emission-tomography.
  • Survival was negatively influenced by histology (epithelioid vs biphasic vs sarcomatoid) (p=0.009), positive macroscopic resection margins (p=0.016), metastatic mediastinal lymph nodes (p=0.016), high COX-2 (p=0.0001) expression, low p21 (p=0.0001) expression and low p27 (p=0.001) expression.
  • Conversely, neither the type of surgery (biopsy-plus-pleurodesis vs pleurectomy-decortication vs extrapleural pneumonectomy), nor preoperative SUV(MAX) (> or = 6.0 vs <6.0), or combined therapies (sole radiotherapy vs adjuvant radio-chemotherapy vs neo-adjuvant chemotherapy plus adjuvant radiotherapy) reached a significant level of difference.
  • Cox regression analysis showed that only immunohistochemical triple combination of high COX-2 and low p21 and p27 expression influenced survival (p=0.0001, hazard ratio 4.7, 95% confidence intervals 3-11) regardless of type of treatment.
  • CONCLUSIONS: At Cox regression analysis, a combination of high COX-2 and low p21 and p27 expression resulted in the only negative prognosticator of malignant pleural mesothelioma.
  • [MeSH-major] Biomarkers, Tumor / metabolism. Cyclin-Dependent Kinase Inhibitor p21 / metabolism. Cyclooxygenase 2 / metabolism. Mesothelioma / diagnosis. Pleural Neoplasms / diagnosis. Proliferating Cell Nuclear Antigen / metabolism
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Combined Modality Therapy. Epidemiologic Methods. Female. Humans. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Proteins / metabolism. Neoplasm Staging. Pneumonectomy. Prognosis. Treatment Outcome

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  • [Copyright] Copyright 2010 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.
  • [CommentIn] Eur J Cardiothorac Surg. 2010 Sep;38(3):252-3 [20634085.001]
  • (PMID = 20338775.001).
  • [ISSN] 1873-734X
  • [Journal-full-title] European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
  • [ISO-abbreviation] Eur J Cardiothorac Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / CDKN1A protein, human; 0 / Cyclin-Dependent Kinase Inhibitor p21; 0 / Neoplasm Proteins; 0 / Proliferating Cell Nuclear Antigen; 0 / p27 antigen; EC 1.14.99.1 / Cyclooxygenase 2
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21. Inoue C, Kato S, Higuchi K, Inoue H: [A case of malignant pleural mesothelioma with elevation of G-CSF and CYFRA in the serum and pleural fluid]. Nihon Kokyuki Gakkai Zasshi; 2007 Mar;45(3):243-7
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  • [Title] [A case of malignant pleural mesothelioma with elevation of G-CSF and CYFRA in the serum and pleural fluid].
  • A diagnosis of squamous cell lung cancer was made based on bronchial washing cytology.
  • Persistent high fever and WBC count elevation did not respond to antibiotics, and reduced only after chemotherapy.
  • Both serum G-CSF (217.0 pg/ml) and CYFRA in the pleural effusion (107.1 ng/ml) were elevated.
  • The biopsy of the growing tumor in the right lateral abdominal wall revealed carcinoma with sarcomatous component or biphasic-type malignant pleural mesothelioma (MPM).
  • In spite of chemotherapy and radiation therapy for the abdominal wall tumor, the tumor rapidly progressed and the patient died three months after admission.
  • However, immunohistochemical staining and tissue HABP staining revealed biphasic type MPM.
  • Although CYFRA elevation in the serum and/or the pleural effusion in MPM patients has been previously reported, it has not been reported in any of the 5 MPM patients reported to have G-CSF elevation.
  • Therefore, this is the first reported case of G-CSF-producing MPM with CYFRA elevation in both serum and the pleural effusion.
  • [MeSH-major] Antigens, Neoplasm / metabolism. Granulocyte Colony-Stimulating Factor / biosynthesis. Keratins / metabolism. Mesothelioma / metabolism. Pleural Effusion / metabolism. Pleural Neoplasms / metabolism

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  • (PMID = 17419436.001).
  • [ISSN] 1343-3490
  • [Journal-full-title] Nihon Kokyūki Gakkai zasshi = the journal of the Japanese Respiratory Society
  • [ISO-abbreviation] Nihon Kokyuki Gakkai Zasshi
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antigens, CD44; 0 / Antigens, Neoplasm; 0 / Biomarkers, Tumor; 0 / Keratin-19; 0 / antigen CYFRA21.1; 143011-72-7 / Granulocyte Colony-Stimulating Factor; 68238-35-7 / Keratins
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22. Khadse P, Prabhash K, Pramesh CS, Chaturvedi P, Shet T: Fine-needle aspiration biopsy of pleural metastases from a carcinosarcoma or true malignant mixed tumor of the parotid gland mimicking a mesothelioma. Diagn Cytopathol; 2009 Sep;37(9):680-5
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  • [Title] Fine-needle aspiration biopsy of pleural metastases from a carcinosarcoma or true malignant mixed tumor of the parotid gland mimicking a mesothelioma.
  • Malignant mixed tumor of the parotid is known to have odd sites for metastases.
  • We describe the fine-needle aspiration cytology (FNAC) findings of pleural metastasis from a malignant mixed tumor misdiagnosed as a mesothelioma on cytology at the onset.A 47-year-old man presented to us with breathlessness and a massive pleural effusion with pleural-based nodules.
  • FNAC from the pleural lesions showed myxoid background substance with entrapped cuboidal epithelial cells with atypical nuclei, which were interpreted as mesothelial cells.
  • These cells in contrast to the usual mesothelial cells were not arranged in sheets but rather were huddled in places and formed a pseudoacinar pattern and blended with the myxoid substance.After the diagnosis of a mesothelioma, patient received pemetrexed and cisplatin based chemotherapy with partial response.
  • While on chemotherapy tumor recurred at the primary site in parotid and was confirmed to be a carcinosarcoma on a FNAC and biopsy.To conclude, pleural metastases from a true malignant mixed tumor of the parotid gland can be misdiagnosed as mesothelioma and could occur in the absence of uncontrolled disease at primary site.
  • Both mesotheliomas and pleomorphic adenomas metastatic to the pleura are biphasic tumors, but in a patient with history of pleomorphic adenoma, the latter should be kept as a foremost possibility.
  • Attention to the cytomorphology of tumor cells will also assist in confirming the diagnosis.
  • [MeSH-major] Carcinosarcoma / secondary. Mesothelioma / pathology. Neoplasms, Complex and Mixed / secondary. Parotid Neoplasms / pathology. Pleural Neoplasms / secondary
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biopsy, Fine-Needle. Cisplatin / administration & dosage. Diagnosis, Differential. Diagnostic Errors. Glutamates / administration & dosage. Guanine / administration & dosage. Guanine / analogs & derivatives. Humans. Male. Middle Aged. Neoplasm Recurrence, Local / pathology. Pemetrexed. Pleural Effusion, Malignant / etiology

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  • [Copyright] 2009 Wiley-Liss, Inc.
  • (PMID = 19373913.001).
  • [ISSN] 1097-0339
  • [Journal-full-title] Diagnostic cytopathology
  • [ISO-abbreviation] Diagn. Cytopathol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Glutamates; 04Q9AIZ7NO / Pemetrexed; 5Z93L87A1R / Guanine; Q20Q21Q62J / Cisplatin
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23. Attanoos RL, Gibbs AR: The pathology associated with therapeutic procedures in malignant mesothelioma. Histopathology; 2004 Oct;45(4):393-7
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  • [Title] The pathology associated with therapeutic procedures in malignant mesothelioma.
  • AIMS: To describe iatrogenic pathological lesions in malignant pleural mesothelioma.
  • METHODS AND RESULTS: All cases of malignant pleural mesothelioma confirmed by antemortem pleural biopsy and undergoing post mortem examination over a 7-year period (1995-2001) formed the study group.
  • This comprised 48 malignant pleural mesotheliomas [epithelioid (n = 21), biphasic (n = 14) and sarcomatoid (n = 13)].
  • Twenty-eight of 48 (58%) had received chemical (talc) pleurodesis, 30/48 (63%) palliative localized radiotherapy, 6/48 (13%) chemotherapy, and 14/48 (30%) surgery [12/48 (26%) pleural decortication and 2/48 (4%) pleuropneumonectomy].
  • CONCLUSIONS: Talc pleurodesis induces a marked pseudosarcomatous fibroblastic proliferation which may impart a biphasic pattern to the neoplasm.
  • In 6/8 (75%) of these cases, comparative assessment of the locally irradiated subcutaneous chest wall tumour, with background pleural mesothelioma, showed no morphological difference in architectural tumour growth pattern, extent of necrosis, cytological or nuclear pleomorphism, mitotic activity or tumour immunophenotype.
  • All six malignant pleural mesotheliomas receiving chemotherapy appeared refractory to treatment in that chemotherapy did not appear to have any significant effect on the tumour morphology, cytonuclear pleomorphism, mitotic activity, extent of necrosis or immunophenotype.
  • In the 12 decortication specimens and two pleuropneumonectomy resections, post mortem examination identified evidence of residual malignant mesothelioma of similar morphological subtype and immunophenotype to the resected tumour.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Mesothelioma / therapy. Pleural Neoplasms / therapy. Pleurodesis. Radiotherapy
  • [MeSH-minor] Diagnosis, Differential. Humans. Iatrogenic Disease. Talc / therapeutic use. Treatment Outcome

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  • (PMID = 15469478.001).
  • [ISSN] 0309-0167
  • [Journal-full-title] Histopathology
  • [ISO-abbreviation] Histopathology
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 14807-96-6 / Talc
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24. Nakas A, Trousse DS, Martin-Ucar AE, Waller DA: Open lung-sparing surgery for malignant pleural mesothelioma: the benefits of a radical approach within multimodality therapy. Eur J Cardiothorac Surg; 2008 Oct;34(4):886-91
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Open lung-sparing surgery for malignant pleural mesothelioma: the benefits of a radical approach within multimodality therapy.
  • OBJECTIVE: To identify the optimal debulking procedure in patients with malignant pleural mesothelioma who are not suitable for extrapleural pneumonectomy (EPP).
  • RESULTS: The two groups were similar for age and gender distribution but epithelioid type was more predominant in group R: 78% compared to 55% epithelioid in group NR.
  • More patients in group R received adjuvant chemotherapy (65% vs 28%, p=0.000) and radiotherapy (65% vs 26%, p=0.000).
  • Median survival for all cell types was significantly higher in group R (15.3 months vs 7.1 months, p<0.000).
  • For epithelioid cell type there was still a significant median survival advantage in group R (25.4 months vs 10.2 months, p<0.000), but there was no difference for sarcomatoid (9.3 months vs 3.2 months, p=0.16) or biphasic cell types (9.4 months vs 7 months, p=0.38).
  • CONCLUSION: If a patient with epithelioid MPM is fit enough to tolerate a thoracotomy then macroscopic clearance of the tumour is the preferred option as part of a multimodality regime including chemotherapy.
  • [MeSH-major] Mesothelioma / surgery. Pleural Neoplasms / surgery
  • [MeSH-minor] Aged. Chemotherapy, Adjuvant. Cohort Studies. Female. Humans. Male. Middle Aged. Neoplasm Staging. Pneumonectomy / contraindications. Radiotherapy, Adjuvant. Survival Analysis. Thoracotomy / methods. Treatment Outcome

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  • (PMID = 18656373.001).
  • [ISSN] 1873-734X
  • [Journal-full-title] European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
  • [ISO-abbreviation] Eur J Cardiothorac Surg
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] Germany
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25. Neumann V, Rütten A, Scharmach M, Müller KM, Fischer M: Factors influencing long-term survival in mesothelioma patients--results of the German mesothelioma register. Int Arch Occup Environ Health; 2004 Apr;77(3):191-9
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  • [Title] Factors influencing long-term survival in mesothelioma patients--results of the German mesothelioma register.
  • Between 1987 and 2000, the German mesothelioma register recorded a total of 4,455 patients with malignant mesotheliomas.
  • Survival times for 498 (11.2%) patients were available; 155 patients (study group, 3.5% of the total group) survived for more than 2 years and 343 patients (control group, 7.7% of the total group) survived for fewer than 24 months.
  • The proportion of pleural mesotheliomas was more than 90% in both groups, with peritoneal cases comprising 6.5% in the study group and 3.2% in the control group.
  • Histologically, the epithelioid subtype was represented in 58% of the study group, whereas the biphasic subtype predominated (67.6%) in the control group.
  • In the majority of the total group pleural effusions were the first symptoms.
  • Therapeutic data were available in fewer than 40% of all cases.
  • Surgical interventions were performed, partly in combination with radiation and chemotherapy and as alternative treatments.
  • Significant deviations in survival time dependent on therapy applied could not be proved.
  • [MeSH-major] Asbestos / toxicity. Mesothelioma / mortality. Pericardium / pathology. Peritoneal Neoplasms / mortality. Pleural Neoplasms / mortality. Survival Analysis

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  • (PMID = 14991330.001).
  • [ISSN] 0340-0131
  • [Journal-full-title] International archives of occupational and environmental health
  • [ISO-abbreviation] Int Arch Occup Environ Health
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 1332-21-4 / Asbestos
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26. Carbone M, Rizzo P, Powers A, Bocchetta M, Fresco R, Krausz T: Molecular analyses, morphology and immunohistochemistry together differentiate pleural synovial sarcomas from mesotheliomas: clinical implications. Anticancer Res; 2002 Nov-Dec;22(6B):3443-8
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  • [Title] Molecular analyses, morphology and immunohistochemistry together differentiate pleural synovial sarcomas from mesotheliomas: clinical implications.
  • BACKGROUND: Only recently pleural synovial sarcomas (SS) have been definitively identified because of the presence of a characteristic X;18 translocation.
  • SS are sarcomatoid or biphasic malignancies morphologically almost indistinguishable from sarcomatoid or biphasic malignant mesotheliomas (MM).
  • PATIENT AND METHODS: We demonstrated a primary pleural biphasic SS in a patient referred to us has having a biphasic MM.
  • Detection of the t(X:18) translocation using RT-PCR, Southern blot, and DNA sequencing definitively confirmed the diagnosis of SS.
  • CONCLUSION: The differential between pleural SS and MM requires a high degree of suspicion and molecular analyses because morphology (histology, immunohistochemistry and electron microscopy) is insufficient to definitively distinguish between these two malignancies.
  • This differential is critical because patients with pleural SS can be susceptible to chemotherapy, and accordingly are treated, while patients with sarcomatoid MM are resistant to chemotherapy and accordingly are not treated.
  • [MeSH-major] Mesothelioma / diagnosis. Pleural Neoplasms / diagnosis. Sarcoma, Synovial / diagnosis
  • [MeSH-minor] Aged. Chromosomes, Human, Pair 18 / genetics. Chromosomes, Human, X / genetics. Diagnosis, Differential. Humans. Immunohistochemistry. Male. Translocation, Genetic

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  • (PMID = 12552937.001).
  • [ISSN] 0250-7005
  • [Journal-full-title] Anticancer research
  • [ISO-abbreviation] Anticancer Res.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / R0-1 CA-92657
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] Greece
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