Agnes Bilecz (Author), Paul Stockhammer (Author), Dirk Theegarten (Author), Izidor Kern (Author), Marko Jakopović (Author), Miroslav Samaržija (Author), Thomas Klikovits (Author), Mir Alireza Hoda (Author), Balazs Dome (Author), Felicitas Oberndorfer (Author)

Abstract

Malignant pleural mesothelioma (MPM) is a rare malignancy with a dismal prognosis. While the epithelioid type is associated with a more favourable outcome, additional factors are needed to further stratify prognosis and to identify patients who can benefit from multimodal treatment. As epithelioid MPM shows remarkable morphological variability, the prognostic role of the five defined morphologies, the impact of the nuclear grading system and the mitosis-necrosis score were investigated in this study. Methods and results: Tumour specimens of 192 patients with epithelioid MPM from five European centres were histologically subtype d. Nuclear grading and mitosis-necrosis score were determined and correlated with clinicopathological parameters and overall survival (OS). Digital slides of 55 independent cases from The Cancer Genome Atlas (TCGA) database were evaluated for external validation. Histological subtypes were collapsed into three groups based on their overlapping survival curves. The tubulopapillary/microcystic group had a significantly longer OS than the solid/trabecular group (732 days versus 397 days, P = 0.0013). Pleomorphic tumours had the shortest OS (173 days). The solid/trabecular variants showed a significant association with high nuclear grade and mitosis-necrosis score. The mitosis-necrosis score was a robust and independent prognostic factor in our patient cohort. The prognostic significance of all three parameters was externally validated in the TCGA cohort. Patients with tubulopapillary or microcystic tumours showed a greater improvement in OS after receiving multimodal therapy than those with solid or trabecular tumours. Conclusions: Histological subtypes of epithelioid MPM have a prognostic impact, and might help to select patients for intensive multimodal treatment approaches.

Keywords

epiteloidni maligni plevralni mezoteliom;histološki podtipi;epithelioid malignant pleural mesothelioma;histological subtypes;

Data

Language: English
Year of publishing:
Typology: 1.01 - Original Scientific Article
Publisher: John Wiley & Sons Ltd.
UDC: 616-006
COBISS: 2048642929 Link will open in a new window
ISSN: 1365-2559
Views: 1104
Downloads: 619
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Other data

Secondary keywords: Mesothelioma;Anatomy and histology;Diagnosis;Analysis;Solitary fibrous tumour, pleural;Neoplasm grading;Prognosis;Mezoteliom;Anatomija in histologija;Diagnostika;Analiza;Solitarni fibrozni tumor plevre;Ocena stadija novotvorbe;Prognoza;
Source comment: Nasl. z nasl. zaslona; Soavtor iz Slovenije: Izidor Kern; Opis vira z dne 16. 3. 2020;
Pages: str. 55-66
Volume: ǂVol. ǂ77
Issue: ǂiss. ǂ1
Chronology: Jul. 2020
DOI: 10.1111/his.14105
ID: 11890301
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