Evaluation of Malignant Mesothelioma Patients: A Ten Years' Experience

We reviewed malignant pleural mesothelioma (MPM) cases diagno­sed at our hospital between 1993 and 2002 with respect to age, sex, histologic type, diagnostic method, stage, and history of occupati­onal and environmental asbestos exposure. Of 106 patients aged bet­ween 31 and 83 years (mean age 54.75 years), 28 patients (26%) we­re females and 78 (74%) were males. Ninety-one patients (84%) had asbestos exposure, which was found to be occupational in 14 pati­ents (13%), environmental in 41 patients (39%) and both occupa­tional and environmental in 36 (34%). In 15 patients (14%) no as­bestos exposure was reported. Fifty-two patients (49%) were afflicted with the epithelial, 18 (17%) with the mixed, and one patient (1%) with the sarcomatous subtype of MPM. In 35 patients (33%) the his­tologic subtype was not clear. Diagnosis was confirmed by biopsy alo­ne in 43 patients (42%), by cytology alone in 5 patients (5%), by open lung biopsy in 53 (50%), by transthoracic needle aspiration bi­opsy in 3(2%), by skin biopsy in one patient (1%) and by mediasti- notomy in one patient (1%). The majority (76%) of the patients were advanced cases at presentation. Distribution of 106 patients ac­cording to tumor stages I,II,III and IV were 9%, 15%, 54%, and 22% respectively. Pleural effusion was present in 75 patients (71%). En­vironmental asbestos exposure rather than occupational exposure was found to be (73% vs. 47%) a major determinant in the etiology of MPM in this group of Turkish patients.