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Ugo Pastorino



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    MA 14 - Diagnostic Radiology, Staging and Screening for Lung Cancer I (ID 672)

    • Event: WCLC 2017
    • Type: Mini Oral
    • Track: Radiology/Staging/Screening
    • Presentations: 1
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      MA 14.15 - Discussant - MA 14.11, MA 14.12, MA 14.13, MA 14.14 (ID 10839)

      15:45 - 17:30  |  Presenting Author(s): Ugo Pastorino

      • Abstract
      • Presentation
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      Abstract not provided

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    P2.09 - Mesothelioma (ID 710)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Mesothelioma
    • Presentations: 1
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      P2.09-001a - TNM or Tumor Volume for Predicting Prognosis in Malignant Pleural Mesothelioma: Still an Open Debate (ID 10192)

      09:30 - 16:00  |  Author(s): Ugo Pastorino

      • Abstract

      Background:
      Malignant pleural mesothelioma (MPM) is a rare and aggressive tumor. Age, stage (TNM) and histotype are the only recognized prognostic factors but the site of disease makes staging difficult to be defined. Pleural tumor volume (TV) was suggested as an alternative in prognostic evaluation but the evidence is limited. The aim of our study was to assess the prognostic role of TV compared to that of the TNM.

      Method:
      Fifty-two MPM patients (pts), diagnosed in 2002-012, were retrospectively collected. A baseline CT scan was performed. Stage was defined according to TNM (7th edition) and TV was calculated using a dedicated computer system. We divided pts in 2 groups according to mean value of baseline TV(483 cm3 ; range 18-2329 cm3). Information on age, sex, histology, and surgery were collected. We evaluated disease site based on the pleural localization: mediastinal-diaphragmatic-parietal. Kaplan-Meier analysis and log-rank test were performed on OS to determine significant prognostic factors. Cox regression analysis adjusted for the prognostic factors was used for investigating their effect on OS.

      Result:
      Thirty-five pts were men; mean age was 62 years (range:25-74). Forty-four pts had epithelioid and 8 had mixed histology. Twenty-five pts had radical surgery. Six pts were diagnosed in early stage(I-II), 20 in III stage and 26 in IV stage. Median overall survival(OS) was 20.8 months (range:0.3–94.3). OS was significantly associated to: TV, stage (I-II, III, IV), T (T1,1B;T2;T3;T4,4B). Cox models adjusted by age, histology, sex, surgery, were used for investigating the effect of stage group and T separately on OS to avoid multicollinearity. The effect of mean TV on OS was evaluated with the Cox regression adding the number of involved sites to the above covariates. Cox regression analysis showed that: stage III (HR 3.75,95%CI 0.99-14.18;p<0.05) and IV (HR 5.43, 95%CI 1.43-20.68; p<0.01) were predictive of survival. With respect to extent of tumor, T3 and T4 were associated with worse prognosis (HR 4.99, 95%CI 1.84-13.49; p<0.002; HR 4.65, 95%CI 1.61-13.47; p<0.005 respectively). Smaller TV was associated with better survival (HR=2.37, 95%CI 1.05-5.37; p<0.04) irrespective of tumor site.

      Conclusion:
      We reported a significant association between TV and prognosis. However, stage and T seem to be better prognostic factors compared to TV most likely because they provide information also on adjacent organs infiltration. Our results should be interpreted with caution, considering the retrospective nature of our series and the small sample. Further collaborative studies are needed.