Recent research suggests that considerable improvements could be made in the scoring system that physicians use to predict the severity or staging in mesothelioma cases, according to a press release.
Mesothelioma is a severe form of cancer that affects the tissue covering internal organs. The most common type, malignant pleural mesothelioma, affects the tissue surrounding the lungs (called the pleura).
The study, “Specimen weight and volume: important predictors of survival in malignant pleural mesothelioma,” was funded by the Mesothelioma Heroes Foundation of Chicago and published in the European Journal of Cardio-Thoracic Surgery.
The scoring system currently used in mesothelioma, known as tumor/node/metastasis (TNM), includes factors such as the tumor size and whether it has traveled to other body parts, which is known as metastasis. Tumor volume and weight could also be valuable measurements for finding the stage of the malignant pleural mesothelioma. “Staging” a disease is a significant prognostic tool and plays a crucial role in patient management.
Computed tomography (CT) scans and magnetic resonance imaging (MRI) are generally used to determine TNM staging; however, these tools are more precise in measuring tumors such as lung cancer rather than mesothelioma, which can be diffuse, vary in thickness, and have a similar density to surrounding tissues.
Wickii Vigneswaran, M.D., MBA, and a professor at Loyola University Chicago Stritch School of Medicine, joined a team of other researchers to investigate whether measuring tumor volume could also predict the clinical outcomes in mesothelioma. Vigneswaran, who has performed about 200 mesothelioma surgeries, is among only a handful of surgeons in the U.S. who treat mesothelioma surgically.
The team enrolled 116 patients — 21 females and 91 males — with a median age of 68, ranging from 43 to 88. The researchers observed that as the volume and weight of the tumor increased, the median survival decreased:
- In patients with tumors between 0 and 300 ml., the median survival was 26.94 months;
- Patients with tumors weighing 301 to 600 ml. had a median survival of 19.45 months;
- Patients with tumors weighing 601 to 900 ml. had a median survival of 12.68 months; and
- In patients with tumors heavier than 901 ml., median survival was 11.7 months. As a comparison, 901 ml. is equivalent to 30.4 ounces.
The findings, while not surprising, led the authors to suggest that an improved scoring system based also on tumor volume and weight could provide more accurate prognosis and support treatment guidance. Vigneswaran emphasized that the study’s findings need to be confirmed with validation in larger, multicenter studies.