采用多模式方法筛查的胸膜间皮瘤患者的远处转移发生率:我们到底需要多少分期?

Cancers Pub Date : 2024-05-17 DOI:10.3390/cancers16101917
Arberit Hyseni, J. Viehof, Jan Hockmann, Martin Metzenmacher, Wilfried Eberhardt, Ken Herrmann, Hubertus Hautzel, Clemens Aigner, T. Plönes
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摘要

胸膜间皮瘤(PM)是一种侵袭性很强的恶性肿瘤,预后很差。大多数患者只接受全身治疗,但有些患者可能会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非常必要的。我们调查了一组接受多模式治疗的患者的转移模式,以确定分期检查的范围。此外,我们还调查了随访期间转移的发生情况。我们对 2010 年至 2022 年间新诊断和/或接受 PM 治疗的 545 名患者进行了单中心经验调查。我们纳入并进一步分析了接受过天真的治疗并进行过全套脑部成像检查的患者。在所有有脑部成像的患者中,共有54%的患者有可用的18FDG-PET CT扫描。我们还记录了治疗随访期间的转移情况。有110名患者进行了全套脑部成像(CT=89%,MRI=11%),其中54%的脑部成像患者有可用的18FDG-PET CT扫描。在首次诊断时,我们发现有四名患者存在脑转移,这意味着该组患者中有 5.4% 存在脑转移,而在有完整 18FDG-PET CT 数据的亚组中,所有患者中有 13.3% 存在远处非脑转移。在纵向随访过程中,我们发现有 11 名患者在首次确诊后 1.6 年(2 个月至 3.3 年)的中位数时间内未发现转移灶。在间皮瘤患者中,远处转移比以前认为的更为常见。这意味着需要对选择接受多模式治疗的患者进行广泛分期,包括脑成像和18FDG-PET CT。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Incidence of Distant Metastases in Patients with Pleural Mesothelioma Screened for a Multimodal Approach: How Much Staging Do We Really Need?
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 available 18FDG-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 available 18FDG-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 of 18FDG-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 and 18FDG-PET CT.
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