Abstract
Between 1985 and 1994 46 of 662 patients examined by thoracoscopy for secondary malignant
pleural effusion were diagnosed to have diffuse malignant pleural mesothelioma. Mean
patient age was 59 years, with a male: female ratio of 5:1. The right hemithorax was
more frequently involved than the left (55% versus 45%). Pleural fluid cytology revealed
malignancy in 61.5% of cases. All patients were treated thoracoscopically by talc
pleurodesis. Mean patient survival was 9.4 months. Survival after one, two, and 5
years was 37.5%, 12.5%, and 5%, respectively.
The characteristics of mesothelioma and pleural effusion evident in thoracoscopy and
their diagnostic relevance are discussed. We suggest talc instillation as the sole
therapeutic maneuver in evolutioned cases, since the literature and our own experience
indicate that survival is not significantly prolonged by more aggressive surgical
approaches.
Key words
Malignant pleural mesothelioma - Malignant pleural effusion - Talc pleurodesis - Primary
pleural tumor
