2010歐洲呼吸學(xué)會和歐洲胸外科醫(yī)師學(xué)會惡性胸膜間皮瘤診療指南
《2010歐洲呼吸學(xué)會和歐洲胸外科醫(yī)師學(xué)會惡性胸膜間皮瘤診療指南》內(nèi)容預(yù)覽
ABSTRACT: Malignant pleural mesothelioma (MPM) is a rare tumour but with increasingincidence and a poor prognosis. In 2008, the European Respiratory Society/European Society ofThoracic Surgeons Task Force brought together experts to propose practical and up-to-datedguidelines on the management of MPM.
To obtain an earlier and reliable diagnosis of MPM, the experts recommend performingthoracoscopy, except in cases of pre-operative contraindication or pleural symphysis. Thestandard staining procedures are insufficient in ,10% of cases. Therefore, we propose usingspecific immunohistochemistry markers on pleural biopsies. In the absence of a uniform, robustand validated staging system, we advice use of the most recent TNM based classification, andpropose a three step pre-treatment assessment. Patient’s performance status and histologicalsubtype are currently the only prognostic factors of clinical importance in the management ofMPM. Other potential parameters should be recorded at baseline and reported in clinical trials.MPM exhibits a high resistance to chemotherapy and only a few patients are candidates forradical surgery. New therapies and strategies have been reviewed.
Because of limited data on the best combination treatment, we emphasise that patients who areconsidered candidates for a multimodal approach should be included in a prospective trial at aspecialised centre.
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