Radiological evaluation of malignant pleural mesothelioma - defining distant metastatic disease
Author(s)
Collins, Dearbhaile Catherine
Sundar, Raghav
Constantidinou, Anastasia
Dolling, David
Yap, Timothy Anthony
Type
Journal Article
Abstract
Background: Malignant pleural mesothelioma (MPM) is traditionally characterized by local destructive spread of the
pleura and surrounding tissues. Patient outcomes in MPM with distant metastatic dissemination are lacking.
Methods: In this retrospective study, we reviewed a cohort of 164 MPM patients referred to a Phase I trials unit,
aiming to describe identified metastatic sites, and correlate with clinical outcomes.
Results: 67% of patients were diagnosed with distant metastatic disease with a high incidence of bone (19%),
visceral (14%), contralateral lung (35%) and peritoneal metastases (22%). Peritoneal metastases were more likely in
epithelioid versus biphasic/ sarcomatoid MPM (p = 0.015). Overall survival was 23.8 months with no statistical
difference in survival between those with distant metastases and those without.
Conclusions: This report highlights the frequency of distant metastases and encourages further radiological
investigations in the presence of symptoms. In particular, given the relatively high incidence of bone metastases,
bone imaging should be considered in advanced MPM clinical workflow and trial protocols. The presence of distant
metastases does not appear to have prognostic implications under existing treatment paradigms. This cohort of
MPM patients gives an indication of patterns of metastatic spread that are likely to become prevalent as prognosis
improves with emerging treatment paradigms.
Keywords: Mesothelioma, Metastases, Pleural mesothelioma, Bone metastases
pleura and surrounding tissues. Patient outcomes in MPM with distant metastatic dissemination are lacking.
Methods: In this retrospective study, we reviewed a cohort of 164 MPM patients referred to a Phase I trials unit,
aiming to describe identified metastatic sites, and correlate with clinical outcomes.
Results: 67% of patients were diagnosed with distant metastatic disease with a high incidence of bone (19%),
visceral (14%), contralateral lung (35%) and peritoneal metastases (22%). Peritoneal metastases were more likely in
epithelioid versus biphasic/ sarcomatoid MPM (p = 0.015). Overall survival was 23.8 months with no statistical
difference in survival between those with distant metastases and those without.
Conclusions: This report highlights the frequency of distant metastases and encourages further radiological
investigations in the presence of symptoms. In particular, given the relatively high incidence of bone metastases,
bone imaging should be considered in advanced MPM clinical workflow and trial protocols. The presence of distant
metastases does not appear to have prognostic implications under existing treatment paradigms. This cohort of
MPM patients gives an indication of patterns of metastatic spread that are likely to become prevalent as prognosis
improves with emerging treatment paradigms.
Keywords: Mesothelioma, Metastases, Pleural mesothelioma, Bone metastases
Date Issued
2020-12-09
Date Acceptance
2020-11-18
Citation
BMC Cancer, 2020, 20 (1210)
ISSN
1471-2407
Publisher
BioMed Central
Journal / Book Title
BMC Cancer
Volume
20
Issue
1210
Copyright Statement
© The Author(s). 2020
License URL
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000600122000002&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Life Sciences & Biomedicine
Oncology
Mesothelioma
Metastases
Pleural mesothelioma
Bone metastases
CHEMOTHERAPY
Publication Status
Published
Article Number
ARTN 1210