Malignant Pleural Mesothelioma (MPM) is an aggressive tumor linked to asbestos exposure, with a latency period of about 40 years before symptoms appear. Despite affecting a minority of exposed individuals, its risk escalates with prolonged exposure. Originating from mesothelial cells, [ Malignant Pleural Mesothelioma (MPM) ] affected 30,870 globally in 2020, causing 26,278 deaths. Early diagnosis remains challenging due to vague symptoms and latency. Survival rates vary, with better outcomes in early detection and specific subtype cases.
This study objectives are to describe the clinical, histological, radiological, staging, treatment and survival characteristics of all [ Malignant Pleural Mesothelioma (MPM) ] diagnosed between January 2008 and December 2021 at Getafe University Hospital.
Quantitative variables are described by mean and standard deviation. Survival analysis is expressed by Kaplan–Meier method. Approval was obtained from the hospital’s Ethics and Research Committee. Our sample consists of 70 patients diagnosed with [Malignant Pleural Mesothelioma (MPM) ], of which 76% were males (53) with a mean age of 71 years (SD 8.3). The average annual incidence of MPM was 4.89 cases per 100,000 inhabitant.
Asbestos exposure was confirmed in 43 cases (61%) based on medical history. The immunohistochemical characteristics are reflected in Table 1. The most frequent symptoms at diagnosis were dyspnea 41 (59%), followed by chest pain 37 (53%), cough 26 (37%) and weight loss 16 (23%). The diagnostic methods used were thoracoscopy 41 (59%), image-guided pleural biopsy 11 (21%), thoracotomy 5 (17%), thoracentesis 3 (4%). The clinical staging obtained were: I 36 (50%), II 6 (9%), III 11 (16%) and IV 18 (25%).
Pleural effusion was evident in 60 patients (86%). The biochemical characteristics of pleural fluid showed an average pH of 7.34 (SD 0.09), glucose of 89.6 mg/dl (48.7), proteins of 4.59 (0.75) mg/ml, LDH of 604 (508) IU/L, and ADA of 46.7 (88.3) IU/L. The most frequent histological lines were epithelioid 52 (73%), mixed 10 (14%), sarcomatoid 8 (13%). The most frequently treatments received were chemotherapy treatment with carboplatin and pemetrexed in 51 (73%) patients, followed by palliative treatment 11 (16%) and surgical treatment 8 (11%) based on pleurectomy-decortication. Pleurodesis was performed in 21 (30%) patients. The overall median survival was 10 months. Patients who underwent surgical treatment showed a median survival of 17 months, followed by chemotherapy 10 months, and palliative care 3 months.
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