The Incidence of Distant Metastases in Patients with Pleural Mesothelioma Screened for a Multimodal Approach: How Much Staging Do We Really Need?

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Arberit Hyseni - , University Hospital Essen (Author)
  • Jan Viehof - , University Hospital Essen (Author)
  • Jan Hockmann - , University Hospital Essen (Author)
  • Martin Metzenmacher - , University of Duisburg-Essen (Author)
  • Wilfried Eberhardt - , University of Duisburg-Essen (Author)
  • Ken Herrmann - , University of Duisburg-Essen (Author)
  • Hubertus Hautzel - , University of Duisburg-Essen (Author)
  • Clemens Aigner - , University Hospital Essen (Author)
  • Till Plönes - , University Hospital Essen (Author)

Abstract

Pleural mesothelioma (PM) is a very aggressive malignancy with a poor prognosis. Most patients receive systemic treatment only; however, some patients may benefit from multimodality treatment. A precise staging of patients undergoing multimodal treatment is mandatory. We investigated the pattern of metastasis in a cohort of patients screened for multimodal treatment to define the extent of staging examinations. Additionally, we investigated the occurrence of metastasis during follow-up. We investigated a single-center experience of 545 patients newly diagnosed and/or treated with PM between the years 2010 and 2022. Patients who were treated naïvely and had a whole set of imaging of the brain were included and further analyzed. A total of 54% of all patients with cerebral imaging had an available 18FDG-PET CT scan. We also recorded metastasis during treatment follow-up. There were 110 patients who had a whole set of imaging (CT = 89% and MRI = 11%) of the brain, and 54% of all patients with cerebral imaging had an available 18FDG-PET CT scan. We identified four patients with cerebral metastasis at the time of first diagnosis, which means that 5.4% of the cohort had cerebral metastasis and 13.3% of all patients in the subgroup with complete data of 18FDG-PET CT had distant non-cerebral metastasis. During the longitudinal follow-up, we found 11 patients with newly diagnosed metastases after a median time of 1.6 years (range: 2 months to 3.3 years) after first diagnosis without metastases. Distant metastases are more frequent in mesothelioma patients than previously thought. This implies that extensive staging is needed for patients selected for multimodal treatment, including brain imaging and 18FDG-PET CT.

Details

Original languageEnglish
Article number1917
JournalCancers
Volume16
Issue number10
Publication statusPublished - May 2024
Peer-reviewedYes
Externally publishedYes

Keywords

Sustainable Development Goals

ASJC Scopus subject areas

Keywords

  • decortication, eP/D, epithelioid, epp, imaging, MARS trial, mesothelioma, PM