Implementing CT tumor volume and CT pleural thickness into future staging systems for malignant pleural mesothelioma

Abstract Objectives Tumor thickness and tumor volume measured by computed tomography (CT) were suggested as valuable prognosticator for patients’ survival diagnosed with malignant pleural mesothelioma (MPM). The purpose was to assess the accuracy of CT scan based preoperatively compared actual weight resected MPM specimen pathologically assessed thickness, well an analysis their impact on overall (OS). Methods Between 09/2013–08/2018, 74 patients treated induction chemotherapy followed (extended) pleurectomy/decortication ((E)PD). In 53 patients, correlations made between CT-measured -tumor (cTV cTT) (pTW) available values. Further cTV pT/IMIG stage correlated using Pearson correlation. Overall (OS) calculated Kaplan Meier tested log rank test. For correlation OS Kaplan-Meier curves test performed all measurements dichotomized at median. Results Median pathological (pTV) pTW 530 ml [130 – 1000 ml] 485 mg [95 g 982 g] respectively. (IQR) 77.2 (35.0–238.0), median cTT 9.0 mm (6.2–13.7). Significant association found pTV ( R = 0.47, p < 0.001) IMIG 0,001) univariate analysis. Multivariate regression revealed, that only correlates pTV. follow-up time 36.3 months 30 dead 23.7 months. 1-year 3-year 90 26% respectively remained statistically associated OS. Conclusion Preoperatively showed a significant may predict reflection burden, which supports integration into future staging systems.