You and your mesothelioma doctor have been discussing the ins and outs of extended pleurectomy and decortication surgery.
You like what this mesothelioma lung-sparing procedure offers. But the big question in your mind is how much extra time will it buy? Your doctor can’t give you a definitive answer.
The surgery could extend your mesothelioma survival by a month, a year or a decade or two. It would, of course, be nice to know what to expect with at least some certainty.
Researchers from the University of Chicago have some good news for you. They now believe it is possible to make surer mesothelioma survival forecasts after extended pleurectomy and decortication surgery.
The key is taking measurements of tumor volume. This is different from the way doctors traditionally try to predict mesothelioma survival, which is by first determining the tumor’s progression stage.
Mesothelioma Prognosis Using Tumor Volume
Tumor progression staging is figured out by using an internationally recognized standard called TNM Classification of Malignant Tumors.
The “T” in TNM stands for tumor size, which is not the same as tumor volume. The “N” stands for nearby. Cancer doctors tell a lot about a cancer’s future course if nearby organs — especially lymph nodes — are or aren’t involved.
The “M” stands for metastasis. Cancer doctors want to know if — and to what extent — the cancer has spread to other parts of your body.
When you put the “T,” “N” and “M” results together and add them up, your doctor can see which stage your mesothelioma has reached. This offers a rough idea of how long you can expect to survive.
But at best it’s only that — a rough idea. This is where the new approach of measuring tumor volume comes in.
Measuring tumor volume could be a boon to making predictions regarding survival because it offers doctors a better representation of the actual cancer burden you’re carrying around inside you.
Cancer burden is another parameter doctors can use to get a handle on your potential for mesothelioma survival following surgery. As the researchers have now shown, it’s also a very reliable parameter.
“Tumor volume is an independent predictor of survival in patients with malignant pleural mesothelioma…[but we] hypothesized tumor volume is a better predictor of survival,” the researchers wrote in a recent issue of the Journal of Cardiothoracic Surgery.
Malignant Pleural Mesothelioma Patients
To test their hypothesis, the researchers studied 111 malignant pleural mesothelioma patients who had received extended pleurectomy and decortication surgery.
The researchers took into account a number of variables for each patient. These included age, sex and tumor histology and stage.
The breakdown worked out to be 91 men and 20 women. The youngest was 43 years old and the oldest was 88 — this resulted in a median age of 68.
The tumors these study subjects carried inside them ranged in volume from 100 ml to 2,200 ml. That put the median tumor volume at 560 ml.
Even more specifically, 18 of the patients had tumors of less than 300 ml. Thirty-seven had tumors between 301 ml and 600 ml, while tumors in 29 of them were in the 601 ml to 900 ml range. The remaining 25 had tumors larger than that.
The researchers were able to determine that tumor volume offered a pretty good independent gauge of postsurgical mesothelioma survival.
Importantly, the researchers insist that their tumor volume approach is a complimentary method of mesothelioma survival prognostication, not one that will kick the staging approach to the curb.
Researchers recommend using the two together. Doing so may yield the most reliable mesothelioma survival prognosis possible.