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Clinical significance of histologic subtyping of malignant pleural mesothelioma
Luka Brčić, Izidor Kern, 2020

Povzetek: Malignant mesothelioma (MM) is uncommon, but very aggressive tumor arising from the mesothelial cells of pleura, pericardium, peritoneum, and tunica vaginalis. Despite multimodality treatments 5-year survival is only 5% after the diagnosis. Histology and TNM staging system are still the best prognostic factors. Furthermore, histologic subtype of MM determines the clinical management of the patients. According to the 2015 WHO classification, MM is divided into diffuse, localized and well differentiated papillary mesothelioma. Major histologic subtypes of diffuse MM, namely epithelioid, biphasic and sarcomatoid, have different prognosis. However, in the last decade it has become evident that more detailed subclassification and histologic/cytological characterization of MM have prognostic and perhaps predictive implications. In this review, major histologic subtypes and cytological features of MM are presented and their relation with prognosis and predictive biomarkers is discussed.
Ključne besede: malignant mesothelioma, epithelioid malignant mesothelioma, biphasic malignant mesothelioma, sarcomatoid malignant mesothelioma
DiRROS - Objavljeno: 22.06.2020; Ogledov: 87; Prenosov: 38
URL Celotno besedilo (0,00 KB)

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Comparative analysis of prognostic histopathologic parameters in subtypes of epithelioid pleural mesothelioma
Agnes Bilecz, Paul Stockhammer, Dirk Theegarten, Izidor Kern, Marko Jakopović, Miroslav Samaržija, Thomas Klikovits, Mir Alireza Hoda, Balazs Dome, Felicitas Oberndorfer, 2020

Povzetek: 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–necrosi s 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 prognos- tic 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.
Ključne besede: epithelioid malignant pleural mesothelioma, histological subtypes
DiRROS - Objavljeno: 08.07.2020; Ogledov: 12; Prenosov: 9
URL Celotno besedilo (0,00 KB)

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