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Prognosis in this disease is difficult to assess consistently because
there is gre at variability in the time before diagnosis and the rate of disease
progression. Various surgical procedures ma y be possible in selected patients,
providing long-term survival without cure. In large retrospective series of
pleural mesothelioma patients, important prognostic factors were found to be
stage, age, performance status, and histology.

For patients treated with aggressive
surgi cal approaches, factors associated with improved long-term
survival include epithelial histology, negative lymph nodes, and negative
surgical margins. For those patients treated with aggressive surgical approaches,
nodal stat us is an important prognostic factor. Median survival for malignant
local pleural disease has been reported as 16 months
and extensive disease as 5 months. In some inst ances the tumor grows through the
diaphragm making the s ite of origin difficult to assess.

Cautious interpretat ion of treatment results in this disease is imperative because of
the selection differences among series. Effusions, both pleural and
peritoneal, represent major sympt omatic problems for at least two thirds of the
patients. A history of asbestos exposure is reported in about 70 % to 80% of
all cases of mesothelioma.

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