Malignant pleural mesothelioma – present and prospects
Prof. MUDr. Vítězslav Kolek, DrSc.
Klinika plicních nemocí a tuberkulózy FN a LF UP Olomouc
In clinical practice, the majority of tumors affecting pleura are tumors of other primary location, as they generalize. The most common primary tumor in this area is malignant mesothelioma.
Its cause is mostly contact with asbestos and the incidence is increasing even though working with asbestos in European countries is already prohibited. Diagnosis is based primarily on immunohistochemical examination of the tumor. The main treatment has been chemotherapy with the combination of cisplatin and pemetrexed in the last 10 years. Tumor aggression is high, and it cannot be fully cured. The surgical approach is limited by appropriate selection of patients and sufficient experience of the workplace. Extrapleural pneumonectomy is performed and lately preferred enlarged pleurectomy in combination with adjuvant or neoadjuvant chemotherapy or radiotherapy. However, randomized trials did not show any significant prolongation of survival compared to standard chemotherapy. Unfortunately, the same can still be said of a large number of studies with biologically targeted treatment, immunotherapy and other drugs. However, research into the genetic and biological characteristics of the tumor is still ongoing and endeavor to improve patient prognosis is enormous.
malignant pleural mesothelioma, epidemiology, diagnostics, therapy
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