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PubMed1984

Malignant mesothelioma. The University of Minnesota experience.

Between 1950 and 1981, 31 patients with mesothelioma were treated at the University of Minnesota. An average of 0.2 to 0.6 patients were seen per year between 1950 and 1970, and since 1970 there has been an average of 1.4 to 2.4 patients per year. Twenty-seven of the 28 patients with malignant mesothelioma are known or presumed dead. Mesotheliomas occurred in all areas of Minnesota, and 28.6% of the patients had a definite history of asbestos exposure. This was also a probable cause of the disease in an additional 25% of patients. The clinical findings and course of the disease were similar to other series. The median survival of all patients was eight months. Doxorubicin-treated patients survived a median of 16 months (range, 2-36 months). Malignant mesothelioma is being increasingly recognized in Minnesota and has a grim prognosis in spite of doxorubicin therapy.

Adult↗
PubMed1984

Non-asbestos-related malignant mesothelioma. A review.

Malignant mesothelioma is an uncommon, but increasingly important, neoplasm. The existing English-language medical literature concerning non-asbestos-related malignant mesotheliomas was reviewed for evidence of other agents associated with the induction of malignant mesothelioma. Both animal and human data were reviewed. In most reviews of malignant mesothelioma, there are a significant proportion of cases without documented asbestos exposure (range, 0% to 87%). Furthermore, there are several fairly well-documented agents other than asbestos that induce malignant mesothelioma in animals, and strong evidence exists that such is the case in man. In reviews of malignant mesothelioma, the percentage of cases with asbestos exposure varies, but a significant number are apparently not asbestos related. It is believed that sufficient evidence exists to suggest that non-asbestos agents can induce malignant mesotheliomas in man, and additional epidemiologic studies in this area are needed.

Aluminum Silicates↗
PubMed1984

Chemotherapy of diffuse malignant mesothelioma. Phase II trials of single-agent 5-fluorouracil and adriamycin.

Twenty consecutive patients with a confirmed diagnosis of diffuse malignant mesothelioma of the pleura or peritoneum, previously untreated with chemotherapy, were studied in a Phase II trial of single-agent 5-fluorouracil. One partial response of 24 months was seen. Eleven patients were treated with single-agent Adriamycin (doxorubicin) after progression on 5-fluorouracil, and one partial response of 34 months was seen. It is concluded that 5-fluorouracil has only minimal activity in diffuse malignant mesothelioma. Preliminary data suggest that Adriamycin has little activity as a second-line agent.

Adult↗
PubMed1985

Malignant mesothelioma in British Columbia in 1982.

All cases newly diagnosed by a pathologist in 1982 in British Columbia as a malignant mesothelioma of the pleura or peritoneum were reviewed. In men there were 17 cases (incidence rate, 17.0/million/year), and in women 2 cases (1.9/million/year). A history of asbestos exposure (largely in shipyards, construction, or insulation work) was obtained for 14 of 15 men, and 0 of 1 woman. Mineralogic analysis of lung on 6 of the men confirmed that the tumor was associated in every instance with exposure to amosite and crocidolite asbestos; some patients also had elevated levels of tremolite asbestos, presumably reflecting exposure to a chrysotile asbestos product. No unusual levels of asbestos were found in the lungs of the one woman studied. These data show that the incidence rate of mesothelioma in British Columbia has increased nearly six times for men compared to the period 1969 to 1975, but has remained roughly unchanged for women. Almost all of the cases in men in this series could be linked to asbestos exposure.

Asbestos↗
PubMed1989

Verification of the histologic diagnosis of malignant mesothelioma in relation to the binding of an antimesothelial cell antibody.

The diagnostic value of a recently developed polyclonal antibody to mesothelial cells has been tested by means of an immunoperoxidase technique to differentiate mesothelioma from lung carcinoma. All 16 unequivocal mesotheliomas reacted with the antibody, whereas none of the 31 lung carcinomas did, thus confirming the high specificity and the high sensitivity of the antibody. Furthermore, 20 cases of serous membranes tumor, in which major diagnostic disagreement was present when reviewed by the members of the Commission of the European Communities Mesothelioma Panel, were examined. Sixteen of the 20 cases were immunoreactive to the antimesothelial cell antibody, thus establishing their mesothelial origin. Given conventionally fixed and processed tissues, it appears that this antibody may be used as an appropriate diagnostic adjunct to increase the accuracy of the diagnosis of mesothelioma.

Antibodies, Neoplasm↗
PubMed1992

A phase II evaluation of ifosfamide and mesna in unresectable diffuse malignant mesothelioma. A Southwest Oncology Group study.

BACKGROUND: Malignant mesothelioma is a highly treatment-resistant neoplasm. This study represents an attempt to define an effective form of systemic therapy. METHODS: Twenty-six patients with unresectable diffuse malignant mesothelioma were enrolled in Southwest Oncology Group (SWOG) study 8731 and treated with ifosfamide, 2 g/m2 intravenously for 4 days, and mesna 2 g/m2 intravenously for 5 days, every 3 weeks. Patients were either previously untreated with chemotherapy or had at most one prior systemic treatment. RESULTS: Two patients, or 8% (95% confidence interval, 1-25%), achieved partial response, with response durations of 4 and 6 months. One additional patient met criteria for tumor size reduction but not duration criteria. Thirteen (50%) patients had stable disease of 4 months' median duration (range, 1-13 months). The median survival of the entire group was 6.5 months. The dose-limiting toxicity was granulocytopenia (11 patients, < or = 250/microliters). CONCLUSIONS: Ifosfamide/mesna has modest activity in malignant mesothelioma. It could be tested using alternate dosage schedules and in combination with other agents in treating this highly resistant neoplasm.

Adult↗
PubMed1995

Sarcomas and other malignancies of soft tissue, retroperitoneum, peritoneum, pleura, heart, mediastinum, and spleen.

BACKGROUND: Malignant neoplasms of the structural tissues, consisting mostly of soft tissue sarcomas, are morphologically diverse and rarely treated for epidemiologic purposes as individual entities. Our understanding to date of the pattern of occurrence of sarcomas is based largely on reports of limited individual clinic experience or case-control studies, each driven by a single hypothesis, and there have been virtually no descriptions according to specific morphologic type. METHODS: The accumulated coverage of the SEER populations offers an opportunity to correct this deficit. Each of the diagnoses has been reported and coded using a single set of rules and described in relation to the population at risk in terms of age, sex, race, calendar period, anatomic location, and outcome. In addition, each morphologic type has been compared with each of the others with respect to the pattern of occurrence and survival. RESULTS: For most of the individual morphologic entities, the pattern of occurrence is specific and unlike other patterns. Differences according to anatomic site, age, sex, race, and period-specific survival were found. Partly because of changes in diagnostic criteria over the years, differences in secular trend, other than that for Kaposi's sarcoma, could not be verified. Although some types of sarcoma may have important genetic determinants, there is evidence of environmental causation in others; for some varieties both genetic and environmental factors may operate. There is no evidence of improvements in survival. CONCLUSIONS: The most likely basis for the observed patterns are morphology-specific differences in etiology and growth phase. Each of the entities should be considered etiologically distinct and should be studied individually whenever possible.

Adolescent↗
PubMed2000

Mortality from six work-related cancers among African Americans and Latinos.

BACKGROUND: Ethnic minorities have been omitted from many occupational health studies, despite their substantial contributions to the labor force and documented cases of high exposures in some settings. To describe the occurrence of potentially work-related cancers among African American and Latino Workers, we conducted an epidemiologic study based on death certificate data. METHODS: Data were obtained from 21 states during 1985-1992. Directly adjusted proportionate mortality ratios (PMRs) and standardized mortality rate ratios (SRRs) for ages 20-64 years were computed for cancers of the lung, nasal cavity, pleura, and peritoneum, malignant melanoma and leukemia using the mortality data and population counts from the 1990 census. RESULTS: Proportionate mortality was generally low for both groups, but African Americans had higher than expected mortality rates for leukemia and cancers of the lung, nasal cavity, and peritoneum. Industry-specific analyses indicate excess leukemia among African American men in the rubber industry (PMR 2.08, 95% confidence interval (CI) 1.29 - 3.35), Latino men in textile (PMR 2. 31, 95% CI 0.81 - 5.13) and wood industries (PMR 2.03, 95% CI 0.81 - 5.13), and Latino women in the chemical industry (PMR 2.18, 95% CI 0.59 - 8.10), among other findings. Excess cancer of the pleura and peritoneum was observed among workers with a variety of usual occupations, consistent with widespread exposure to asbestos. CONCLUSIONS: This study demonstrates the utility of surveillance data bases for generating basic epidemiologic information on historically neglected workers. Leads about specific workplace exposure can be followed up in more detailed studies.

Adult↗
PubMed1991

The incidence of malignant mesothelioma in Australia 1982-1988.

From 1980 to 1985, the Australian Mesothelioma Surveillance Program, and since 1986, the Australian Mesothelioma Register, have been collecting data on all cases of malignant mesothelioma that could be ascertained in Australia. Incidence rates were calculated on 854 Program and 696 Register cases (total 1271) diagnosed in Australia between January 1, 1982 and December 31, 1988. Australia has one of the highest national rates of mesothelioma in the world (15.8 cases per million of population aged 20 years and older), and the rate is rising. The rate is far higher in males (28.3) than females (3.3). The Western Australian rate (28.9) is the highest among the states, as may be expected because of the crocidolite mine at Wittenoom; however, the largest numbers of cases occur in the more populous and industrial New South Wales. The high incidence rate, its expected continuing increase, and absence of a history of exposure to asbestos in approximately 28% of cases, demand consideration of potential environmental factors other than asbestos in the causation of this tumor, as well as continued surveillance.

Adult↗
PubMed1992

Death certificates in epidemiological studies, including occupational hazards: inaccuracies in occupational categories.

We compared death certificates for asbestos-associated diseases (mesothelioma, lung cancer, asbestosis) in two asbestos workers' cohorts. One (insulation workers) had current or recent employment and a strong, continuing union support system which gave them much information about the effects of asbestos exposure. The second cohort, asbestos factory workers, had no such advantage. The factory had closed almost 30 years before, and its workers had dispersed into many areas of the state and nation. Accuracy of medical diagnosis was comparable in the two groups, but occupational listings were not. Three-quarters of the insulators' death certificates told of asbestos work, while virtually none of the factory workers' certificates provided such information, even for deaths of mesothelioma and asbestosis. The data indicate that disease categories, based on medical and pathological diagnoses, at least for asbestos-associated disease, tend to be accurate. Attempts to identify groups at risk by sorting occupational categories can give variable results, good for those with current exposures, much less satisfactory for those with long-past occupational exposures.

Adolescent↗
PubMed1993

Characterization of asbestos fibers in lungs and mesotheliomatous tissues of baboons following long-term inhalation.

Changes in the dimensions of inhaled asbestos fibers in the lung and translocation of intrapulmonary asbestos fibers into mesothelial tissues were investigated in 17 baboons (5 exposed to amosite, 4 to chrysotile, 5 to crocidolite, and 3 unexposed). The animals received different cumulative doses of asbestos by inhalation, followed by varying recovery periods (0-69 months). All asbestos types induced pulmonary asbestosis with severity directly related to the cumulative dose. There were a larger number of asbestos bodies in the lung of the amphibole-exposed animals than in those exposed to chrysotile. A tissue burden study, using transmission electron microscopy on 25-microns paraffin sections, ashed in a low-temperature asher, was performed. Intrapulmonary amosite fibers were shorter in geometric mean length compared with a standard amosite sample (UICC) (3.3 microns). In explanation, it was considered that long fibers might not be able to reach the lower respiratory tract and/or long fibers might be fragmented into shorter fibers. Further, in the amosite-exposed group, the mean length of intrapulmonary fibers increased with the extension of recovery period, suggesting that shorter fibers had been cleared from the lung. The chrysotile standard sample (UICC) had a shorter geometric mean length (1.1 microns) than amosite. The mean length of intrapulmonary chrysotile did not noticeably change with the extension of inhalation and recovery periods; however, the mean width decreased with the extension of these periods. This finding strongly suggested that separation of thick chrysotile fibers had occurred in the lung. The crocidolite standard sample (Transvaal) had a shorter geometric mean length (1.4 microns) than amosite.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1989

Ultrastructural histochemistry of mesotheliomas and adenocarcinomas in malignant effusions.

The results of electron microscopic examination of cytologic specimens from six cases of mesothelioma and 10 cases of metastatic carcinoma of different origins are presented. The formation of cell clusters in malignant effusions from the two neoplasms has been thoroughly investigated: in mesotheliomas, cells had longer, more slender microvilli than in carcinomas and more abundant bundles of intermediate filaments; the central cavity often seen in the clusters frequently contained collagen and showed basement membrane production. The application of periodic acid-silver methenamine (PASM) and phosphotungstic acid (PTA) demonstrated a peculiar ultrastructural difference in cell coat staining in the two tumor types: in mesotheliomas, PTA and PASM were consistently negative along the outer surface of the cell aggregates, while carcinomas displayed a positive reaction either on the outer surface or on both inner and outer surfaces of the clusters. The diagnostic significance of the above-mentioned difference between the two neoplasms will require further investigation in a larger number of cases.

Adenocarcinoma↗
PubMed1993

Cytopathology of malignant mesothelioma: a study of its patterns and histological bases.

We have reviewed the effusion cytology of 51 cases of histologically proven malignant mesothelioma of the pleura (49 cases) and the peritoneum (2 cases). The patient group included 45 males and 6 females, aged 45-83 yr. A cytological diagnosis of malignancy had been rendered on 43 cases, and in 30 of them it was consistent with, or at least suggestive of, a mesothelioma. Diagnostic clues, especially evident in epithelial and biphasic tumors were hypercellularity and/or morular aggregates of malignant cells showing scalloped borders and nuclei with dense chromatin and evident nucleoli. Cytomegaly with multinucleation was also frequently observed. Reactive mesothelial cells were often present along with other non specific features such as red blood cells, fibrin, necrotic debris. In 13 cases, a diagnosis of malignancy was entertained but mesothelioma, although considered, was not reported out because of scantiness of material. In four cases, adenocarcinoma was erroneously diagnosed for the presence of deceptive cell vacuoles. In eight cases, no diagnostic cells were recovered in repeated effusions. The first diagnosis was a cytologic one in 37 patients, Tissue study was performed on autopsy (35 patients) and surgical material. The latter was the only source of histology in six cases. Immunocytochemical investigation was negative for carcinoembryonic antigen in all but one tested cases (1/21) and positive for human milk fat globulin in about one-half of the epithelial and biphasic tumors. In 18 of 21 cases, positivity for combined high- and low-molecular-weight keratins was detected.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗