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Clinicopathological features of radiological early malignant pleural mesothelioma with no apparent tumor or pleural thickening.

Authors
  • Nakamura, Akifumi1
  • Hashimoto, Masaki2
  • Kodama, Hiroshi3
  • Yuki, Michiko4
  • Kondo, Nobuyuki2
  • Yamakado, Koichiro3
  • Tsujimura, Tohru4
  • Kijima, Takashi5
  • Hasegawa, Seiki2
  • 1 Division of Thoracic Surgery, Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan. [email protected] , (Japan)
  • 2 Division of Thoracic Surgery, Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan. , (Japan)
  • 3 Department of Radiology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan. , (Japan)
  • 4 Department of Pathology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan. , (Japan)
  • 5 Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan. , (Japan)
Type
Published Article
Journal
International journal of clinical oncology
Publication Date
Jan 01, 2021
Volume
26
Issue
1
Pages
95–103
Identifiers
DOI: 10.1007/s10147-020-01780-0
PMID: 32914367
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

We occasionally encounter malignant pleural mesothelioma (MPM) of no apparent tumor or pleural thickening that is radiological early MPM. This study aimed to examine the clinicopathological outcomes of radiological early MPM. Patients with MPM treated with neoadjuvant chemotherapy and planned surgery at the time of diagnosis between July 2004 and December 2019 were retrospectively examined. Pretreatment maximal pleural thickness of all patients was measured on chest computed tomography. We extracted and investigated the patients who exhibited a lack of pleural thickening or visible tumor, which was defined as radiological early MPM. Survival was analyzed by the Kaplan-Meier method. Of 296treated patients, 16 (5.4%) exhibited radiological early MPM. Fourteen (87.5%) of these patients underwent pleurectomy/decortication and 2 (12.5%) underwent extrapleural pneumonectomy. Pathological stage T1 disease was diagnosed in 14 (87.5%) patients; 2 (12.5%) exhibited pulmonary parenchymal invasion (pathological stage T2). Lymphatic invasion was detected in only 1 patient. Lymph node metastases and vascular invasion were not detected. Median follow-up was 42 months. Median progression-free survival and median overall survival were 40.7 and 56.1 months, respectively. The 3-year progression-free survival and overall survival rates were 84.8% and 83.6%, respectively. Radiological early MPM occurs in approximately 1 of every 20 patients treated with neoadjuvant chemotherapy and surgery planned at the time of diagnosis in an experienced center. Radiological early MPM was associated with early pathological stage and long-term survival.

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