Avtor/Urednik     Debevec, Miha; Kovač, Viljem; Debeljak, Andrej; Eržen, Janez; Remškar, Zlata; Kern, Izidor
Naslov     Maligni plevralni mezoteliom: analiza bolnikov v Sloveniji 1980-1997
Prevedeni naslov     Malignant pleural mesothelioma: analysis of patients in Slovenia 1980-1997
Tip     članek
Vir     Zdrav Vestn
Vol. in št.     Letnik 69, št. 9
Leto izdaje     2000
Obseg     str. 599-606
Jezik     slo
Abstrakt     Background. Malignant pleural mesothelioma (MPM) is rare tumor and in Slovenia its incidence is increasing. In order to improve the control of MPM the analysis of 18 years period was carried out. Methods. Retrospective study of reachable diseases documentation and data of Cancer Registry of Slovenia for 156 patients with microscopically confirmed tumor was performed considering the exposure to asbestos. Results. MPM incidence in Slovenia in this period was 0.4/100,000 population. Of 120 males and 36 females aged 23 to 90 years (median 60 years) at the end of follow up on Dec. 31, 1999 only 3 were alive. Overall survival at one year was 33%, and at 5-year 4% (median 5.5 months). Exposure to asbestos was registered in 24% of patients. The largest group of patients-46 lived in Maribor and its surroundings and along river Soča in neighborhood of Anhovo-39 patients. Most common symptom was thoracic pain (52%). Troubles of disease before diagnosis lasted up to 4 years. Chest x-ray showed the most commonly pleural effusion (57%). Histopathologic classification was performed as epithelial in 24%, sarcomatoid in 6%, and biphasic in 8%, while in remaining patients MPM was undetermined. In most, i.e. 100 patients, primary therapy was symptomatic, 24 patients were operated on, but in half of them only explorative thoracotomy was made. Median survival of 12 operated patients was 16 months. MPM was cause of death in 95%. In 41 patients autopsy was performed. Conclusions. Good prognostic factors were: initial stage, good performance status and epithelial cell subtype. The management of our patients with MPM up to the present was not adequate. For better control of MPM, the consistent registration of exposure to asbestos and more accurate diagnostics were necessary. As MPM is rare tumor, it would be properly to enroll our patients in to an international MPM clinical trial.
Izvleček     Izhodišča. Maligni plevralni mezoteliom (MPM) je redek tumor, toda njegova incidenca v Sloveniji narašča. Da bi izboljšali nadzor nad MPM, smo naredili analizo 18-letnega obdobja. Metode. Retrospektivna študija na podlagi dosegljivih popisov bolezni in podatkov Registra raka za Slovenijo zajema 156 bolnikov z mikroskopsko potrjenim tumorjem, upoštevajoč izpostavljenost azbestu. Rezultati. Incidenca MPM v tem obdobju je bila v Sloveniji 0,4/100.000 prebivalcev. Od 120 moških in 36 žensk, starih od 23 do 90 let (mediana 60 let), so ob koncu dobe opazovanja 31.12.1999 živeli samo trije bolniki. Eno leto je preživelo 33%, pet let 4% bolnikov (srednje preživetje 5,5 meseca). Stik z azbestom je registriran pri 24% bolnikov. Največ bolnikov, 46, je bilo z območja Maribora in njegove širše okolice ter ob Soči v področju Anhovega, od tam je bilo 39 bolnikov. Najpogostejši bolezenski simptom je bila bolečina v prsnem košu (52%). Bolezenske težave pred ugotovitvijo bolezni so trajale štiri leta. Na rentgenski sliki pljuč je bila najpogostejša sprememba plevralni izliv (57%). Histološko je bil tumor opredeljen kot epiteloidni pri 24%, sarkomatoidni pri 6%, bifazni pri 8% bolnikov, pri ostalih pa tip MPM ni bil določen. Največ, to je 100 bolnikov, je bilo primarno zdravljenih simptomatsko, 24 bolnikov pa je bilo operiranih, a je bila pri polovici narejena samo eksplorativna torakotomija. Srednje preživetje 12 operiranih bolnikov je bilo 16 mesecev. Vzrok smrti je bil v 95% MPM. Obduciranih je bilo 41 bolonikov. Zaključki. Ugodni napovedni dejavniki so: začetni stadij bolezni, dobra telesna zmogljivost in epiteloidni histološki tip. Dosedanja obravnava bolnikov z MPM ni bila na ustrezni ravni. Za boljši nadzor nad tem tumorjem je potrebna dosledna registracija izpostavljenosti azbestu in natančnejša diagnostična obdelava bolnikov. Ker gre za redko vrsto tumorja, bi bilo smiselno vključiti naše bolnike v eno izmed mednarodnih študij MPM.
Deskriptorji     PLEURAL NEOPLASMS
MESOTHELIOMA
NEOPLASM STAGING
SURVIVAL ANALYSIS
PROGNOSIS
REGISTRIES
RETROSPECTIVE STUDIES
SLOVENIA