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Concerning CT Findings and Mesothelioma Prognosis

ByAlex Strauss

Concerning CT FindingsOne of the nation’s top mesothelioma doctors says concerning CT findings may be one of the best ways to predict peritoneal mesothelioma outcomes. 

Dr. Paul Sugarbaker is with MedStar Washington Hospital Center in Washington, DC. His newly published study compares 11 different concerning CT findings with outcomes in 100 mesothelioma patients. 

Sugarbaker and his team found that the prognostic value of these 11 CT features is on a par with peritoneal cancer index (PCI) and cytoreduction (CC) score. It means that CT findings could become even more important for mesothelioma treatment planning. 

CT Scans Reveal Information About Peritoneal Mesothelioma

Peritoneal mesothelioma occurs on the lining around the abdomen. It is an aggressive and hard-to-treat cancer caused by exposure to asbestos. CT scanning is one of the primary tools doctors use to diagnose mesothelioma.

Especially in people with a history of asbestos exposure, concerning CT findings are a red flag for mesothelioma. CT scans take multiple X-ray images from different angles. The images get compiled into a single three-dimensional model. 

Among other things, a CT scan can show if the peritoneal membrane is getting thicker. It can also show a buildup of fluid in the abdomen. These are radiological  signs of early mesothelioma. 

The Prognostic Value of Concerning CT Findings

Dr. Sugarbaker and his team wanted to determine just how indicative concerning CT findings could be. They identified 11 different findings that could be cause for concern. Then they looked at the incidence of these features on preoperative CT scans of 100 peritoneal mesothelioma patients. 

Between 5 and 41 percent of patients had some of these concerning CT findings. Nine of the 11 findings turned out to be statistically significant in predicting reduced mesothelioma survival.

The CT information compared favorably with two other prognostic tools – PCI and CC score. The peritoneal cancer index is a measure of exactly how much cancer is present in the abdomen. The CC score measures how much of it is successfully removed during surgery. 

“The prognostic information from concerning CT features compared favorably with the prognostic implications of PCI and CC score,” reports Dr. Sugarbaker.

The team concludes that concerning CT findings “may be of great value” to doctors trying to plan treatment for individual peritoneal mesothelioma patients. 

About a fifth of the mesothelioma cases diagnosed in the US each year are the peritoneal variety. Scientists believe that peritoneal mesothelioma may result from swallowing asbestos dust. Toxic asbestos fibers lodge in the abdominal tissue and never leave the body. 

Source: 

Sugarbaker, P, et al, “Concerning CT features predict outcome of treatment in patients with malignant peritoneal mesothelioma”, April 14, 2021, European Journal of Surgical Oncology, Online ahead of print, https://linkinghub.elsevier.com/retrieve/pii/S0748798321004170

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