New research suggested that measuring tumor size may help to predict survival in patients with malignant pleural mesothelioma. The study, “Tumor volume is an independent predictor of survival in patients with malignant pleural mesothelioma,“ appeared in the Journal of Cardiothoracic Surgery.
Pleural mesothelioma refers to a tumor of the lung lining, and can lead to a thickening of lung tissue and trouble breathing. The one-year survival rate of patients is low, only 38 percent, and thought to be linked mostly to a failure to correctly detect or diagnose the disease. Identifying factors that may predict survival could aid in the understanding and treatment of the condition.
Currently, doctors classify pleural mesothelioma using what is known as the TNM classification, but this method is not always accurate for survival prediction. TNM stands for “tumor, nodes and metastasis.”
In the study led by Diana Kircheva of the Department of Surgery, University of Chicago Medicine, a team of researchers wanted to understand whether tumor size might better predict survival. The team studied 111 people with pleural mesothelioma and compared the TNM method to assessments of tumor size.
Study participants, 91 men and 20 women ranging in age from 43 to 88 (median age 68), underwent extended pleurectomy and decortication (EPD). This is a two-part surgery involving removal of the lung’s lining in the first step (pleurectomy), and the removal of visible tumors (decortication) as the second step. Survival over two years following diagnosis was 48.3%, and from EPD was 31.5%.
The investigators found that the size of the tumor (volume) predicted survival with statistically meaningful effect. There was no measured relationship, however, between TNM classification and the volume of the tumor.
In their report, the investigators noted, “Tumor volume is an independent predictor of survival in patients with [pleural mesothelioma] undergoing EPD. Tumor volume is an important measure and is complimentary to TNM staging.”
Measurements of tumor volume are currently not a standard clinical assessment for people with malignant pleural mesothelioma, but one that might be implemented to better predict survival compared to current standards.
The main cause of pleural mesothelioma cancer is asbestos exposure.