文章：

多模式方法筛查胸膜间皮瘤患者远处转移发生率：我们究竟需要多少分期？

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

原文发布日期：17 May 2024

DOI: 10.3390/cancers16101917

类型: Article

开放获取: 是

英文摘要：

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 available18FDG-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 available18FDG-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 of18FDG-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 and18FDG-PET CT.

摘要翻译： 

胸膜间皮瘤（PM）是一种侵袭性强、预后不良的恶性肿瘤。大多数患者仅接受全身治疗，但部分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要的。本研究通过分析一组接受多模式治疗筛查患者的转移模式，以明确分期检查的范围，并进一步探究随访期间转移的发生情况。我们回顾性分析了2010年至2022年间单中心收治的545例新诊断和/或治疗的PM患者数据，筛选出初治且完成全套脑部影像学检查的患者进行深入分析。在所有接受脑部影像检查的患者中，54%同时具备可用的¹⁸FDG-PET CT扫描数据。此外，我们记录了治疗随访期间出现的转移事件。结果显示：110例患者完成了全套脑部影像检查（CT占89%，MRI占11%），其中54%的患者拥有¹⁸FDG-PET CT数据。在初诊时发现4例脑转移患者（占队列的5.4%），而在拥有完整¹⁸FDG-PET CT数据的亚组中，13.3%的患者存在非脑部远处转移。纵向随访发现，11例初诊无转移的患者在中位1.6年（范围：2个月至3.3年）后出现新发转移。研究表明，间皮瘤患者的远处转移发生率高于既往认知，这意味着对选择多模式治疗的患者需要进行包括脑部影像和¹⁸FDG-PET CT在内的全面分期评估。

原文链接：

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