Low-Dose Computed Tomography Screening for Lung Cancer and Pleural Mesothelioma in an Asbestos-Exposed Population: Baseline Results of a Prospective, Nonrandomized Feasibility Trial—An Alpe-Adria Thoracic Oncology Multidisciplinary Group Study (ATOM 002)

Fasola, Gianpiero; Belvedere, Ornella; Aita, Marianna; Zanin, Tina; Follador, A.; Cassetti, Paolo; Meduri, Stefano; Pangher, V. De; Pignata, Giusto; Rosolen, Valentina; Barbone, Fabio; Grossi, Francesco

doi:10.1634/theoncologist.12-10-1215

Cited by 70 publications

(40 citation statements)

References 26 publications

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“…Tobacco smoking and asbestos exposure history did not have any significant effect on the existence of nodules. The current findings conflict somewhat with those of Fasola et al, who found no relation between age or asbestos exposure and nodules, but instead found smoking in excess of 25 pack-years as a positive predictor for nodules [10]. Due to the small number of women the potential sex effect could not reliably be explored in this material.…”

Section: Discussioncontrasting

confidence: 99%

Factors influencing the prevalence of pulmonary nodules in lung cancer screening trials: re-evaluation of a CT study

Vehmas¹

2008

Upsala Journal of Medical Sciences

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Numerous false positive findings are a problem in computed tomography based lung cancer screening trials. The potential patient-related variables that could predict the existence of such lung nodules were studied. 526 construction workers (age 38-81 yrs.) previously screened with spiral computed tomography were evaluated. Background features (age, body mass index, stature, sex, C-reactive protein, erythrocyte sedimentation rate, asbestos exposure and smoking history), reported symptoms (general condition, cough, mucous production, dyspnoea, chest pain) and findings in high resolution CT were related to the existence of nodules with logistic regression. There were 107 patients with one or more nodules recorded at least by two of the three observers. Advancing age (OR = 1.042/year, 95% CI = 1.000-1.085, p = 0.048) and dyspnoea symptom (p = 0.014) were positively associated with the existence of nodules, while smoking, asbestos exposure history and other studied parameters were not. Nodules ≤ 5 mm (50 patients) were inversely associated with the maximal thickness of pleural plaques (OR = 0.384, 95% CI = 0.169-0.873, p = 0.022). No variables helpful to sample subjects for lung cancer screening studies to reduce the number of false positive findings were found. Poor inspiration or associated pathology such as thick pleura may hamper nodule detection. Further studies should focus especially on the possible effect of computer tomography technology on finding nodules.

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Section: Discussioncontrasting

confidence: 99%

Factors influencing the prevalence of pulmonary nodules in lung cancer screening trials: re-evaluation of a CT study

Vehmas¹

2008

Upsala Journal of Medical Sciences

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“…Low-dose computed tomography (CT) scan has not been proven to be an effective screening tool for the detection of early MPM: no single case of pleural mesothelioma was detected in a cohort of 1,045 asbestos exposed workers [24]. Positron emission tomography (PET) scan and magnetic resonance imaging (MRI) are imaging techniques that are useful in the clinical management of malignant pleural diseases and in the differentiation of malignant from benign pleural disease, but are not available and/or applicable for screening purposes.…”

Section: Statementmentioning

confidence: 99%

Guidelines of the European Respiratory Society and the European Society of Thoracic Surgeons for the management of malignant pleural mesothelioma

Scherpereel¹,

Astoul²,

Baas³

et al. 2009

Eur Respir J

548

504

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Malignant pleural mesothelioma (MPM) is a rare tumour but with increasing incidence and a poor prognosis. In 2008, the European Respiratory Society/European Society of Thoracic Surgeons Task Force brought together experts to propose practical and up-to-dated guidelines on the management of MPM.To obtain an earlier and reliable diagnosis of MPM, the experts recommend performing thoracoscopy, except in cases of pre-operative contraindication or pleural symphysis. The standard staining procedures are insufficient in ,10% of cases. Therefore, we propose using specific immunohistochemistry markers on pleural biopsies. In the absence of a uniform, robust and validated staging system, we advice use of the most recent TNM based classification, and propose a three step pre-treatment assessment. Patient's performance status and histological subtype are currently the only prognostic factors of clinical importance in the management of MPM. Other potential parameters should be recorded at baseline and reported in clinical trials. MPM exhibits a high resistance to chemotherapy and only a few patients are candidates for radical surgery. New therapies and strategies have been reviewed.Because of limited data on the best combination treatment, we emphasise that patients who are considered candidates for a multimodal approach should be included in a prospective trial at a specialised centre.

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“…From 2002 to 2009, the results of some lung cancer screening trials with LDCT on asbestos-exposed workers were published (29)(30)(31)(32)(33)(34). Unfortunately, in these studies CT image acquisition and reconstruction algorithms are different as well as technical parameters (mA, slice thickness, reconstruction interval, additional HRCT slices, etc.…”

Section: Ldct Lung Cancer Screening In Asbestos-exposed Workersmentioning

confidence: 99%

Imaging of malignant pleural mesothelioma: it is possible a screening or early diagnosis program?—a systematic review about the use of screening programs in a population of asbestos exposed workers

Falaschi¹,

Romei²,

Fiorini

et al. 2018

J. Thorac. Dis.

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Malignant pleural mesothelioma (MPM) in an uncommon neoplasia with high mortality rate, mostly related to professional asbestos exposure. Clinical manifestations are not specific so that diagnosis is performed at advanced stage and screening protocols are not feasible now. On the other hand, asbestosexposed workers have a high incidence of developing lung cancer. Low-dose computed tomography (LDCT) is a volumetric acquisition technique with high spatial resolution and a low dose exposure; it is used in many trials to detect lung tumours at an early stage in screening protocols, reducing mortality rate in smoker subjects. In recent papers, the possibly role of lung cancer screening was evaluated and recommended also in subjects exposed to asbestos. This article summarizes previous and present clinical trials validated for lung cancer screening, to discuss the possibility of early diagnosis or screening programs in a population of asbestos exposed workers by LDCT.

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Low-Dose Computed Tomography Screening for Lung Cancer and Pleural Mesothelioma in an Asbestos-Exposed Population: Baseline Results of a Prospective, Nonrandomized Feasibility Trial—An Alpe-Adria Thoracic Oncology Multidisciplinary Group Study (ATOM 002)

Cited by 70 publications

References 26 publications

Factors influencing the prevalence of pulmonary nodules in lung cancer screening trials: re-evaluation of a CT study

Factors influencing the prevalence of pulmonary nodules in lung cancer screening trials: re-evaluation of a CT study

Guidelines of the European Respiratory Society and the European Society of Thoracic Surgeons for the management of malignant pleural mesothelioma

Imaging of malignant pleural mesothelioma: it is possible a screening or early diagnosis program?—a systematic review about the use of screening programs in a population of asbestos exposed workers

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