Differential Survival Characteristics of Sarcomatoid Subtype in Biphasic Pleural Mesothelioma

Abstract

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Surgical Management of Malignant Pleural Mesothelioma: From the Past to the Future

“…Conversely, absolute contraindications are patients with sarcomatoid or sarcomatoid-predominant histology, pN2 disease (according to Eighth Edition TNM staging system) and/or stage IV, unless in the context of clinical trials [1,8,30,31]. Despite the overall poor prognosis of biphasic histology, according to recent multicentre analyses, a multimodal approach, including cancer-directed surgery, seems to be associated with improved long-term results in very selected patients with biphasic MPM [31,32], mostly in patients with a lower proportion of sarcomatoid disease [33]. The ipsilateral nodal disease is not an absolute contraindication for surgery, in fact, the pattern of lymphatic drainage of the pleura does not follow the same pathway as for the lung parenchyma; mediastinal nodes may be the initial site of metastases before the lung parenchyma is involved.…”

Contemporary issues in the surgical management of pleural mesothelioma

“…In univariate analysis, age and preoperative lung function were associated with survival. We did not measure the extent of sarcomatoid histology in tumor specimens, which has been demonstrated as an important prognostic factor in previous studies 60,61 …”

“…We did not measure the extent of sarcomatoid histology in tumor specimens, which has been demonstrated as an important prognostic factor in previous studies. 60,61 Several previously described PM prognostic scores are based on patients undergoing chemotherapy, 62,63 while surgical-based models have been limited. [64][65][66] 65 includes ECOG PS, pretreatment TV, serum albumin, and serum neutrophil/lymphocyte ratio as clinical parameters.…”

Highlighting the immunohistochemical differences of malignant mesothelioma subtypes via case presentations

“…The preferred treatment option for all MM subtypes is surgical resection, and a favourable outcome has been reported when combined with chemo‐ or radiotherapy, although relapse is still fairly common 9,13–15 . Regardless of the therapeutic options, the prognosis of diffuse MM remains dismal.…”

“…The preferred treatment option for all MM subtypes is surgical resection, and a favourable outcome has been reported when combined with chemo‐ or radiotherapy, although relapse is still fairly common. 9 , 13 , 14 , 15 Regardless of the therapeutic options, the prognosis of diffuse MM remains dismal. Amin and coauthors analyzed 888 cases of pleural and peritoneal MM, and in their study, the median overall survival of these patients was 15 months, with better outcomes in patients with peritoneal involvement.…”