title: Clinical aspects of malignant mesothelioma in Australia.
abstract: Australia is currently experiencing an epidemic of malignant mesothelioma. The clinical aspects of malignant mesothelioma were investigated in 295 Australian patients as part of a national study of the disease. Most patients were male (91%), with the mean age at diagnosis being 64 years. The predominant cell type was epithelial (38%) and the majority of primary tumours arose from the pleura (94%). Mean survival was poor (17.6 months from first symptom; 11.8 months from diagnosis). Patients with a pleural primary tumour were more likely to present with dyspnoea, chest pain and cough; to have a pleural effusion diagnosed radiologically; and to have metastatic spread. Patients with a peritoneal primary tumour were more likely to present with weight loss, loss of appetite, abdominal pain and ascites; to have radiologic evidence of asbestos exposure; and to have spread along a needle track created during a diagnostic tap. A minority of patients had past thoracic conditions, or radiologic findings, specifically related to previous asbestos exposure. About one fifth of patients had no known asbestos exposure. Forty-one per cent of subjects received some form of chemotherapy, radiotherapy and/or surgery, but no formal disease staging had been documented for any patient. Proper controlled trials of secondary and tertiary treatments in malignant mesothelioma are now needed.
authors: Epidemiology and Surveillance Unit, National Institute of Occupational Health and Safety, Worksafe, Australia.
authors: T R
authors: TR
authors: Driscoll
authors: G J
authors: GJ
authors: Baker
authors: S
authors: S
authors: Daniels
authors: J
authors: J
authors: Lee
authors: R
authors: R
authors: Thompson
authors: D A
authors: DA
authors: Ferguson
authors: J
authors: J
authors: Leigh
mesh_terms: D000368:Aged; D001194:Asbestos / Q000009:adverse effects; D001315:Australia / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008654:Mesothelioma / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000556:secondary; D008875:Middle Aged; D012042:Registries; D016019:Survival Analysis; D013899:Thoracic Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology
chemical_list: D001194:Asbestos