Hyseni Arberit, Viehof Jan, Hockmann Jan, Metzenmacher Martin, Eberhardt Wilfried, Herrmann Ken, Hautzel Hubertus, Aigner Clemens, Plönes Till
Department of Thoracic Surgery and Endoscopy, Ruhrlandklinik, West German Cancer Center, University Hospital, University of Duisburg-Essen, 45239 Essen, Germany.
Department of Medical Oncology, West German Cancer Center, University Clinic Essen, University of Duisburg-Essen, 45147 Essen, Germany.
Cancers (Basel). 2024 May 17;16(10):1917. doi: 10.3390/cancers16101917.
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 FDG-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 FDG-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 FDG-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 FDG-PET CT.
胸膜间皮瘤（PM）是一种极具侵袭性的恶性肿瘤，预后较差。大多数患者仅接受全身治疗；然而，一些患者可能从多模式治疗中获益。对接受多模式治疗的患者进行精确分期是必不可少的。我们调查了一组接受多模式治疗筛查的患者的转移模式，以确定分期检查的范围。此外，我们还调查了随访期间转移的发生情况。我们研究了2010年至2022年间在单中心新诊断和/或接受PM治疗的545例患者的情况。纳入并进一步分析了初治且进行了全套脑部成像检查的患者。所有进行脑部成像的患者中，共有54%进行了FDG-PET CT扫描。我们还记录了治疗随访期间的转移情况。有110例患者进行了全套脑部成像检查（CT占89%，MRI占11%），所有进行脑部成像的患者中，54%进行了FDG-PET CT扫描。我们在首次诊断时发现4例脑转移患者，这意味着该队列中有5.4%的患者发生了脑转移，在有FDG-PET CT完整数据的亚组中，所有患者中有13.3%发生了远处非脑转移。在纵向随访中，我们发现11例患者在首次诊断无转移后，中位时间1.6年（范围：2个月至3.3年）出现了新诊断的转移。间皮瘤患者的远处转移比以前认为的更常见。这意味着对于选择接受多模式治疗的患者，需要进行广泛的分期检查，包括脑部成像和FDG-PET CT。
