Mesothelioma: Planet Earth

Stahel RA, Weder W, Felip E, Anonymous00129. · Clinic and Policlinic of Oncology, University Hospital of Zürich, Switzerland. · Ann Oncol. · Pubmed #18456764 links to  free full text

This publication has no abstract.

Marchevsky AM, Wick MR. · Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA. · Appl Immunohistochem Mol Morphol. · Pubmed #17525624 No free full text.

Abstract: There are no firmly established guidelines for the use of antibodies in immunohistology as individual tests or panels. Practicing pathologists must rely on information available in individual publications, review articles, books, and internet-based databases to develop diagnostic immunohistochemical algorithms for their individual practices. In contrast, other medical specialties have crafted many evidence-based practice guidelines (EBG) that are widely used; these have helped to augment standardization and cost effectiveness. In particular, the use of several "epithelial" and "mesothelial" antibodies has been proposed to distinguish epithelioid malignant mesothelioma from metastatic pulmonary adenocarcinoma. Other authors have previously done systematic literature reviews of this subject up through 2004 and integrated the results of 88 publications into summarized test-performance values for 15 preselected immunohistochemical markers. The results suggested that 7 tests provide optimal sensitivity and specificity (MOC-31, BG8, CEA, TTF-1, CK5/6, WT-1, and HBME-1), but they provide no guidance for integration of such data into EBG. Odds ratios (ORs) were employed to compare the effectiveness of any single test, and chosen combinations thereof, in the differential diagnosis of malignant mesothelioma and metastatic pulmonary adenocarcinoma. Surprisingly, selected single immunostains or antibody pairs yielded ORs (varying from 96.34 to 1233.19) that were equal or better in efficacy when compared with more comprehensive panels. These results support the potential value of systematic reviews, meta-analysis, and OR calculations for development of EBG in diagnostic immunohistology.

Anonymous00082, Manegold C. · No affiliation provided · Ann Oncol. · Pubmed #17491037 links to  free full text

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Ellis P, Davies AM, Evans WK, Haynes AE, Lloyd NS, Anonymous00155. · McMaster University at Hamilton Health Sciences and Juravinski Cancer Centre, Hamilton, Ontario, Canada. · J Thorac Oncol. · Pubmed #17409924 No free full text.

Abstract: BACKGROUND: This clinical practice guideline, based on a systematic review, was developed to determine which chemotherapeutic agents (or combinations of agents) show the highest response rates, improved survival, quality of life, or symptom control in patients with advanced malignant pleural mesothelioma. METHODS: A thorough systematic search of the literature was conducted for published articles and conference proceedings for applicable abstracts. Relevant trials, published as articles and abstracts, were selected and assessed. External feedback was obtained from Ontario clinicians, and the guideline was approved by the provincial Lung Cancer Disease Site Group. RESULTS: One hundred nineteen studies were eligible, including eight randomized trials and 111 phase II trials. The pooled response rates from phase II trials suggest that response rates with combination chemotherapy are higher than with single agents. Data from the largest randomized controlled trial demonstrated that chemotherapy with cisplatin and pemetrexed significantly improves response rates (41% versus 17%, p < 0.001), time to progression (5.7 months versus 3.9 months, p = 0.001), and overall survival (median, 12.1 months versus 9.3 months, hazard ratio = 0.77, p = 0.020) in comparison to single-agent cisplatin. A second trial demonstrated cisplatin and raltitrexed significantly improved median survival compared to single-agent cisplatin (11.4 months versus 8.8 months; hazard ratio = 0.76, p = 0.0483). Overall response rate (24% versus 14%, p = 0.056) was greater in the combination treatment arm, but this difference was not statistically significant. CONCLUSIONS: There is good evidence to recommend chemotherapy with pemetrexed and cisplatin for adult patients with symptomatic advanced malignant pleural mesothelioma. Such treatment should be administered with supplementation of vitamin B12 and folic acid. If pemetrexed is not available, cisplatin plus raltitrexed is a reasonable alternative.

Butnor KJ, Sporn TA, Ordonez NG, Anonymous00042. · Department of Pathology, University of Vermont, 111 Colchester Avenue, Burlington, VT 05401, USA. · Hum Pathol. · Pubmed #17276491 No free full text.

Abstract: It has been evident for decades that pathology reports are very variable even within a single institution. Standardization of reporting is the optimal way to ensure that information necessary for patient management, prognostic and predictive factor assessment, grading, staging, analysis of outcomes, and tumor registries is included in pathology reports. In recent years, 2 societies (first the Association of Directors of Anatomic and Surgical Pathology [ADASP] and then the College of American Pathologists [CAP]) have undertaken to publish guidelines for the reporting of common cancers. The CAP assigned multidisciplinary groups of pathologists, surgeons, radiation, and medical oncologists to develop the protocols. Other pathologists and clinicians then reviewed them. After those reviews the protocols were reviewed by multiple CAP committees and finally approved by the Board of Governors. The ADASP, in contrast, chose a pathologist expert in each filed to assemble a group from within the pathology community (with clinician input if desired) to write specific cancer protocols. These were then approved by the ADASP council and subsequently by the membership. Although both societies began the process at approximately the same time, the streamlined approach adopted by the ADASP enabled them to publish years earlier in pathology journals frequented by anatomic pathologists. Although the formats are somewhat different, the contents are essentially the same. The American College of Surgery Commission on Cancer (COC) accredits cancer centers in the United States. Recently, the COC decided to require elements, deemed as essential by the CAP, to be described in all pathology reports in their accredited cancer centers as of January 2004. Importantly, they do not require that the specific CAP protocols or synoptic reports be used. The ADASP has updated all of its protocols to comply with the COC requirements in the form of 37 uniform checklists. The checklists use the staging criteria sited in the American Joint Committee on Cancer 2002 Staging Manual (sixth edition) but include a variety of other references listed in each of the checklists. Moreover, the checklists are formatted for ease of use. They may be used as templates for uniform reporting and are designed to be compatible with voice-activated transcription. The different elements in these revised ADASP diagnostic checklists have been divided into required and optional. The term required in this context only signifies compliance with the COC guidelines. The ADASP realizes that specimens and practices vary, and it will not be possible to report these elements in every case. However, the ADASP hopes that pathologists will find these checklists to be useful in daily clinical practice, while facilitating compliance with the new COC requirements.

Anonymous00024. · No affiliation provided · Am J Clin Pathol. · Pubmed #17145632 links to  free full text

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Scherpereel A, Anonymous00398. · INSERM Unit 774, Institut Pasteur de Lille, France. · Respir Med. · Pubmed #17137779 No free full text.

Abstract: Previously considered as a rare tumor, malignant pleural mesothelioma (MPM) has become a very important public health issue. In fact, MPM is a tumor with a poor survival, and its incidence is expected to continue to increase for at least the next 10 years. Asbestos exposure is the main factor involved in MPM pathogenesis. The diagnosis of MPM may be difficult because of differential diagnosis such as pleural benign disease induced by asbestos exposure or pleural metastasis of adenocarcinoma. Management of patients with MPM also remains complicated because they are often referred for evaluation late in the evolution of the disease. Moreover, MPM exhibits a high resistance to radiotherapy and chemotherapy; only few patients are candidates for radical surgery. New therapeutic strategies such as gene or cell therapy are still on clinical trial. Therefore, an optimal treatment of MPM is not clearly defined yet, despite the introduction of recent drugs. Between April 2005 and January 2006, the French Speaking Society for Chest Medicine (SPLF), in collaboration with other French scientific societies, brought together experts on mesothelioma to draw up recommendations in order to provide clinicians with clear, concise, up-to-date guidelines on management of MPM, presented in this report.

Kavanagh M, Ouellet JF, Anonymous00221. · Direction de la lutte contre le cancer, Ministère de la Santé et des Services sociaux du Québec, 1075, chemin Sainte-Foy, 7e étage, Québec, QC, G1S 2M1, Canada. · Bull Cancer. · Pubmed #16980229 links to  free full text

Abstract: In 2005, the Comité de l'évolution des pratiques en oncologie (CEPO) took it upon itself to develop a clinical practice guideline to determine the clinical value of surgical cytoreduction followed by hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) for treating peritoneal carcinomatosis stemming from colorectal cancer, cancers of the appendix and stomach, pseudomyxoma peritonei, and mesothelioma of the peritoneum. A review of the scientific literature was performed using the PubMed search engine. The period covered extended from January 1990 to January 2006, inclusively. The scientific literature search was limited to clinical trials (minimum phase II) and organizations elaborating clinical practice recommendations. Twenty-six studies were identified. Of these, only one was phase III. Although some of these studies have demonstrated a benefit from this treatment in terms of patient survival, HIPEC remains a complex procedure whose optimal use is uncertain. Given the morbidity and mortality associated with this treatment, this procedure requires a high level of expertise. Considering the evidence available, the CEPO recommends: 1) that complete cytoreduction followed by HIPEC be used in a clinical research context only, preferably in the presence of an isolated peritoneal carcinomatosis stemming from colorectal cancer, cancer of the appendix, peritoneal pseudomyxoma, or mesothelioma of the peritoneum; 2) that studies be conducted only in specialized centers with the necessary expertise and technical resources.

Anonymous00140. · No affiliation provided · Rev Mal Respir. · Pubmed #16820752 No free full text.

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Hering KG, Jacobsen M, Bosch-Galetke E, Elliehausen HJ, Hieckel HG, Hofmann-Preiss K, Jacques W, Jeremie U, Kotschy-Lang N, Kraus T, Menze B, Raab W, Raithel HJ, Schneider WD, Strassburger K, Tuengerthal S, Woitowitz HJ, Anonymous00018. · Knappschaftskrankenhaus, Klinik für Radiologie und Nuklearmedizin, Dortmund. · Pneumologie. · Pubmed #14569528 No free full text.

Abstract: The ILO (1980) Classification has been revised during recent years. The new version is now available as the International Classification of Radiographs of Pneumoconioses (Revised edition 2000). The Guidelines booklet is currently available only in English. Those involved felt it was important to maintain continuity with the ILO (1980) edition, in particular to retain the standard radiographs, despite their restricted quality, so as to ensure comparability with earlier national and international data sets. The standard films illustrating pleural abnormalities, and 'u'-shadows, have been modified and reconstituted. The most important changes relate to assessment of film quality, pleural abnormalities, and additional symbols. In Germany, film quality is characterised as "+", "+-", "+--" and "u" according to whether the ability to assess pneumoconiosis is judged to be unimpeachable ("+") to unusable ("u"). If a film is not classified as "+", then written comments regarding defects are required. For "diffuse" pleural thickening, the ILO (2000) edition now requires the presence also of obliteration of the costophrenic angle. This was not required in the earlier (1980) edition and, as previously, is also not stipulated in the German version. A minimum width of 3 mm (previously 0-5 mm), coded "a", is required both for plaques as well as for the margin to the lateral chest wall. Congruence is thus achieved for criteria, which, in German practice, lead to an indication of suspect occupational disease. Plaques on the diaphragm are not considered for measurement of extent; they are only coded as present or absent. If calcification is identified, then this must also be classified and measured as a localised plaque. Extent of calcification on its own, previously coded "0" to "3", is no longer specified. The following new symbols, illustrated by new diagrams, have been introduced: aa = atherosclerotic aorta; at = apical thickening; cg = calcified granuloma (or other non-pneumocononiotic nodules); me = mesothelioma (already previously differentiated from "ca" on the German record sheet); pa = plate atelectasis; pb= parenchymal bands; ra = rounded atelectasis; od = other disease. (Examples of the latter are illustrated diagrammatically by lobar pneumonia, aspergilloma, goiter and hiatal hernia.) Earlier national differences (ILO 1980/German Federal Republic) on particular issues have also been agreed among German "double-readers" ["Zweitbeurteiler"]. However, conformity between the original (ILO 2000) text and the national (German) modified text has been retained in large measure. The detailed descriptions of the standard films differ in certain respects from the German (1980) definitions. Some revision of individual descriptions of the films are proposed. Except for a few differences, agreement was reached here too. The definitive date for the change in Germany is expected to be in early 2004. The standard films are already available now through ILO offices in Geneva or Bonn (addresses in appendix.)

Downs FM, Giles GM, Johnson MJ. · Strathcarron Hospice, Fankerton, Denny, Stirlingshire, UK. · Palliat Med. · Pubmed #12465702 No free full text.

Abstract: Mesothelioma caused by occupational exposure to asbestos is well recognized and sufferers who have been employed in a prescribed occupation can claim compensation. Stringent criteria must be fulfilled in order to establish the link between occupational exposure and mesothelioma, and to this end the procurator fiscal is involved after the patient's death, both to elucidate the individual situation and 'for the common good'. Problems were experienced locally by the use of uniformed police officers, as the appointed Crown agents, as interviewers of recently bereaved relatives, irrespective of the degree of tact and sensitivity shown. The likelihood of an autopsy was also distressing. It is important to recognize the role of the procurator fiscal and to ensure that workers' compensation procedures exist and are followed. However, in order to minimize grief and distress to relatives, discussion took place with the local procurator fiscal. He was appreciative of the issues raised and practice has now changed substantially. In particular, police officers are no longer required to interview relatives either for the purpose of identification or to ascertain the deceased's occupational history. A pro forma has been produced and agreed locally to obviate the need for medical staff to be interviewed by police officers. Following subsequent discussion with the Crown Office our local arrangements have been incorporated in Crown Office guidance for national use.

Ruffié P, Lehmann M, Galateau-Sallé F, Lagrange JL, Pairon JC, Anonymous00204. · Institut Gustave Roussy, Villejuif, France. · Br J Cancer. · Pubmed #11355969 links to  free full text

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Nash G, Otis CN. · Department of Pathology, Baystate Medical Center, Springfield, Mass, USA. · Arch Pathol Lab Med. · Pubmed #9923835 No free full text.

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Newman Taylor A. · No affiliation provided · Occup Environ Med. · Pubmed #19541802 No free full text.

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Terracini B. · No affiliation provided · Epidemiol Prev. · Pubmed #19353958 No free full text.

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Stayner LT. · No affiliation provided · J Occup Environ Med. · Pubmed #19092485 No free full text.

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Anonymous131061. · No affiliation provided · Lancet. · Pubmed #19059033 No free full text.

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Morrison PJ. · No affiliation provided · Ulster Med J. · Pubmed #18956793 links to  free full text

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van Meerbeeck JP, Hillerdal G. · No affiliation provided · Am J Respir Crit Care Med. · Pubmed #18832552 No free full text.

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Hansell A. · No affiliation provided · Am J Respir Crit Care Med. · Pubmed #18755931 No free full text.

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The Lancet Oncology. · No affiliation provided · Lancet Oncol. · Pubmed #18598922 No free full text.

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Passlick B. · No affiliation provided · Zentralbl Chir. · Pubmed #18563682 No free full text.

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Hengge UR. · No affiliation provided · Onkologie. · Pubmed #18322409 No free full text.

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Brochard P. · No affiliation provided · Rev Pneumol Clin. · Pubmed #18166940 No free full text.

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Sugarbaker PH. · No affiliation provided · Gastroenterol Clin Biol. · Pubmed #18166852 No free full text.

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