Computed tomography in the evaluation of malignant pleural mesothelioma-Association of tumor size to a sarcomatoid histology, a more advanced TNM stage and poor survival

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Paajanen , J , Laaksonen , S , Ilonen , I , Wolff , H , Husgafvel-Pursiainen , K , Kuosma , E , Ollila , H , Myllärniemi , M & Vehmas , T 2018 , ' Computed tomography in the evaluation of malignant pleural mesothelioma-Association of tumor size to a sarcomatoid histology, a more advanced TNM stage and poor survival ' , Lung Cancer , vol. 116 , pp. 73-79 . https://doi.org/10.1016/j.lungcan.2018.01.001

Title: Computed tomography in the evaluation of malignant pleural mesothelioma-Association of tumor size to a sarcomatoid histology, a more advanced TNM stage and poor survival
Author: Paajanen, Juuso; Laaksonen, Sanna; Ilonen, Ilkka; Wolff, Henrik; Husgafvel-Pursiainen, Kirsti; Kuosma, Eeva; Ollila, Hely; Myllärniemi, Marjukka; Vehmas, Tapio
Contributor: University of Helsinki, Department of Surgery
University of Helsinki, Clinicum
University of Helsinki, Clinicum
Date: 2018-02
Language: eng
Number of pages: 7
Belongs to series: Lung Cancer
ISSN: 0169-5002
URI: http://hdl.handle.net/10138/300968
Abstract: Objectives: Appropriate clinical staging of malignant pleural mesothelioma (MPM) is critical for correct treatment decisions. Newly revised TNM staging protocol has been released for MPM. We investigated baseline computed tomography (CT) characteristics of MPM patients, the new staging system and a simple tumor size (TS) assessment in terms of survival. Materials and methods: As part of our study that included all MPM patients diagnosed in Finland 2000-2012, we retrospectively reviewed 161 CT scans of MPM patients diagnosed between 2007 and 2012 in the Hospital District of Helsinki and Uusimaa. TS was estimated by using the maximal tumor thickness and grading tumor extension along the chest wall. Cox Regression models were used to identify relationships between survival, clinicopathological factors and CT-findings. Results: The median length of follow-up was 9.7 months and the median survival 9.1 months. The right sided tumors tended to be more advanced at baseline and had worse prognosis in the univariate analyses. In the multivariate survival model, TS, pleural effusion along with non-epithelioid histology were predictors of poor survival. Tumor size correlated significantly with a sarcomatoid histopathological finding and several parameters linked to a more advanced TNM stage. Most patients were diagnosed with locally advanced stage, while 12 (7%) had no sign of the tumor in CT. Conclusion. In this study, we demonstrate a novel approach for MPM tumor size evaluation that has a strong relationship with mortality, sarcomatoid histology and TNM stage groups. TS could be used for prognostic purposes and it may be a useful method for assessing therapy responses.
Subject: Mesothelioma
Computed tomography
Tumor size
Staging
ASBESTOS-RELATED DISEASE
FORTHCOMING 8TH EDITION
IASLC MESOTHELIOMA
PROGNOSTIC-FACTORS
PROJECT PROPOSALS
CLASSIFICATION
RISK
CT
DESCRIPTORS
RELIABILITY
3122 Cancers
3121 General medicine, internal medicine and other clinical medicine
3126 Surgery, anesthesiology, intensive care, radiology
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