The prognosis in malignant Pleural Mesothelioma is tough to evaluate consistently as there is quite a bit of variation in the time before diagnosis and the rate of malignant Pleural Mesothelioma progression. A number of surgical routines may be implemented in selected patients, offering long-term survival without a cure. In most Pleural Mesothelioma patients, significant factors for prognosis are age, stage, histology and performance status.
For individuals treated with aggressive surgical routines, factors linked with improved long-term survival are negative surgical margins, negative lymph nodes and epithelial histology. A record of asbestos exposure is reported in about 75% of all Mesothelioma cases.
Histologically, Mesothelioma tumors are comprised of epithelial and fibrous elements. According to a recent study, the epithelial form causes plenty of confusion with metastatic carcinomas. A needle biopsy of the pleura is not going to be effective in diagnosis. It is tough distinguishing between Mesothelioma and carcinoma on small tissue specimens. However, a thoracoscopy can be quite useful in getting the correct tissue specimens for diagnostic purposes. Gross tumor examination at the time of surgery can also be useful and the use of electron microscopy is recommended.
Individuals with stage I of the disease have a much better prognosis in comparison to those with stages II or III. Because malignant Pleural Mesothelioma is quite rare, there is not much information available on survival. The staging system is set on the basis of thoracic surgery and the TNM staging system.
- Stage I: Malignant Pleural Mesothelioma confined within the parietal pleura capsule
- Stage II: Everything that is there in the stage I alongside positive intrathoracic lymph nodes
- Stage III: Local extension of malignant Pleural Mesothelioma into the chest wall and heart
- Stage IV: Distant metastatic disease
It is advisable that you go for a standard treatment rather than aggressive ones. There are a number of side effects associated with aggressive treatment routine. An extra-pleural pneumonectomy in some of the patients may prove effective in the long run. According to recent research, decortication and pleurectomy can give you relief from symptomatic effusions and pain occurring because of tumor burden. The use of radiation therapy and chemotherapy after surgery also gives temporary relief.
Localized Malignant Mesothelioma
- Solitary Mesotheliomas: Surgical resection en bloc comprises of contiguous structures which play a prominent part in getting rid of symptoms. Your health care provider will employ sessile polypoid lesions
- Intracavitary Mesothelioma: Intracavitary Mesothelioma is treated through radiation therapy. In some cases, you will also find extrapleural pneumonectomy.
Advanced Malignant Mesothelioma Treatment Options
- Symptomatic treatment including thoracoscopic pleurodesis, drainage of effusions and chest tube pleurodesis
- Palliative surgical resection is also being performed on some individuals
- Palliative radiation therapy
- Single-agent chemotherapy
- Intracavitary therapy is performed on selected patients. It includes intrapleural and intraperitoneal administration of chemotherapeutic agents. Some of the chemotherapeutic agents that are used in the therapy are cytarabine, cisplatin and mitomycin. These agents play a significant part in minimizing the tumor size and controlling pain.
Recurrent Malignant Mesothelioma
Recurrent malignant Mesothelioma treatment normally uses routines and agents that are not used initially. There is no standard treatment available at present that can control the symptoms of malignant Pleural Mesothelioma.