While it may seem obvious that larger mesothelioma tumors result in shorter survival times, tumor volume is not typically used to determine mesothelioma prognosis.
In an article in the Journal of Cardiothoracic Surgery, the research team argues that it should be.
Determining Mesothelioma Prognosis
Clinicians typically use a classification system known as TNM to determine cancer stage and predict mesothelioma survival.
TNM takes into account the size of the mesothelioma tumor (T) and whether it has spread to surrounding tissues, whether lymph nodes in the region are involved (N), and whether mesothelioma cells have spread or metastasized to other parts of the body (M).
Evaluating Mesothelioma Surgery Patients
But the University of Chicago team says mesothelioma tumor volume may be just as important in predicting survival as the T or N portions of the current staging system.
They evaluated the cases of 111 mesothelioma patients who underwent a lung sparing surgery called extended pleurectomy and decortication (EPD).
After surgery, the team assessed mesothelioma outcomes based on age, gender, histology, tumor volume, and T and N stage..
A Better Way to Predict Mesothelioma Survival?
The research team used a water displacement method to determine the volume of each mesothelioma tumor that was removed during surgery.
The median tumor volume among the 91 men and 20 women was 560 ml, with the largest percentage of mesothelioma patients falling in the 301 to 600 ml range.
The team found that, while tumor volume was directly related to T stage, there was no relationship between the volume of a mesothelioma tumor and N stage (lymph node involvement).
“Tumor volume is an independent predictor of survival in patients with malignant pleural mesothelioma undergoing EPD…and is complimentary to TNM staging,” concludes Diana Kircheva, whose name appears first on the paper.
An estimated 2,500 Americans receive a mesothelioma diagnosis each year.
Kircheva, D, et al, Tumor volume is an independent predictor of survival in patients with malignant pleural mesothelioma, December 18, 2015, Journal of Cardiothoracic Surgery, Epub ahead of print