The presence of nonexpandable lung can be an independent predictor of mortality in mesothelioma, according to research published in the Annals of the American Thoracic Society. Nonexpandable lung has also been linked to an increase in shortness of breath and coughing.
Researchers conducted a prospective, observational cohort study of patients with mesothelioma to determine the prevalence of nonexpandable lung and evaluate the potential association between nonexpandable lung and survival in this patient population. Participant data (n=229; 85.6% men; mean age, 64 years) were collected from a single center between 2008 and 2017. At baseline, a majority of patients were performance status 0 or 1 (27.1% and 48.5%, respectively). Among the patient population, right-sided tumors were more common than left-sided tumors (58.5% vs 41.1%).
In total, 83.8% of patients presented with pleural effusion. Of these patients, 33.3% had nonexpandable lung, and 76.6% demonstrated preserved pleural apposition over ? 50% of the hemithorax. Among those with nonexpandable lung, 59% of patients had a degree of nonexpandable lung smaller than the size of the overlying pleural effusion. Although left-sided tumors were more common in patients without pleural effusions, right-sided tumors were more frequently associated with both pleural effusion and underlying nonexpandable lung. The group with nonexpandable lung was composed of more men compared with the group with effusion but without nonexpandable lung and the group with no effusion (96.9% vs 81.3% vs 81.1%, respectively). Patients with nonexpandable lung more frequently reported breathlessness and cough (90.6% and 51.6%), in contrast to chest pain, which was least common in this group (34.4%).
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