RT Journal Article
SR Electronic
T1 Impact of tumour thickness on survival after radical radiation and surgery in malignant pleural mesothelioma
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1601428
DO 10.1183/13993003.01428-2016
VO 49
IS 3
A1 Marc de Perrot
A1 Zhi Dong
A1 Penelope Bradbury
A1 Demetris Patsios
A1 Shaf Keshavjee
A1 Natasha B. Leighl
A1 Andrew Hope
A1 Ronald Feld
A1 John Cho
YR 2017
UL http://erj.ersjournals.com/content/49/3/1601428.abstract
AB Tumour thickness was assessed to determine if this parameter could refine patients' selection for multimodality therapy in malignant pleural mesothelioma.We reviewed 65 consecutive treatment-naïve malignant pleural mesothelioma patients undergoing surgery for mesothelioma after radiation therapy (SMART). Total tumour thickness was determined by measuring the maximal thickness on nine predefined sectors on the chest wall, mediastinum and diaphragm.After a median follow-up of 19 months, 40 patients (62%) developed recurrence and 36 died (55%). Total tumour thickness, ranging between 2.4 and 21 cm (median 6.9 cm), correlated with tumour volume (p<0.0001, R2=0.29) and maximum standardised uptake value (p=0.006, R2=0.11). Total tumour thickness had a significant impact on overall survival and disease-free survival in univariate analysis. In multivariate analysis, total tumour thickness remained an independent predictor of survival (p=0.02, hazard ratio (HR) 1.12, 95% CI 1.02–1.23) and disease-free survival (p=0.01, HR 1.13, 95% CI 1.03–1.24) along with epithelial histologic subtype (p<0.0001, HR 0.25, 95% CI 0.13–0.50) and pN2 disease (p=0.03, HR 2.15, 95% CI 1.07–4.33). Diaphragmatic tumour thickness correlated best with time to recurrence (p=0.002, R2=0.22) and time to death (p=0.003, R2=0.2).The impact of tumour thickness on survival and disease-free survival independent of histologic subtypes and nodal disease is extremely encouraging. This parameter could potentially be used to refine the clinical staging of malignant pleural mesothelioma and optimise patient selection for radical treatment.Tumour thickness is an independent predictor of outcome after radical treatment for malignant pleural mesothelioma http://ow.ly/KCbT306wDBN