Comparative analysis of prognostic histopathologic parameters in subtypes of epithelioid pleural mesothelioma.
epithelioid
grading
histological subtypes
mesothelioma
prognosis
Journal
Histopathology
ISSN: 1365-2559
Titre abrégé: Histopathology
Pays: England
ID NLM: 7704136
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
received:
28
12
2019
revised:
09
03
2020
accepted:
10
03
2020
pubmed:
15
3
2020
medline:
7
4
2021
entrez:
15
3
2020
Statut:
ppublish
Résumé
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. Tumour specimens of 192 patients with epithelioid MPM from five European centres were histologically subtyped. 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. Histological subtypes of epithelioid MPM have a prognostic impact, and might help to select patients for intensive multimodal treatment approaches.
Types de publication
Comparative Study
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
55-66Subventions
Organisme : Austrian Science Fund FWF
ID : I 3977
Pays : Austria
Organisme : Austrian Science Fund FWF
ID : I 2872
Pays : Austria
Informations de copyright
© 2020 The Authors. Histopathology published by John Wiley & Sons Ltd.
Références
Shavelle R, Vavra-Musser K, Lee J, Brooks J. Life expectancy in pleural and peritoneal mesothelioma. Lung Cancer. Int. 2017; 2017; 1-8.
Travis WD, Brambilla E, Burke AP, Marx A, Nicholson AJT eds. World Health Organisation classification of tumours of the lung, pleura, thymus and heart, 4th edn. Geneva, Switzerland: WHO, 2015; 78-79.
Kindler HL, Ismaila N, Armato SG III et al. Treatment of malignant pleural mesothelioma: American Society of Clinical Oncology clinical practice guideline. J. Clin. Oncol. 2018; 36; 1343-1373.
Baas P, Fennell D, Kerr KM, Van Schil PE, Haas RL, Peters S. Malignant pleural mesothelioma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann. Oncol. 2015; 26(Suppl. 5); 31-39.
Calabrò L, Rossi G, Maio M. New horizons from immunotherapy in malignant pleural mesothelioma. J. Thorac. Dis. 2018; 10; S322-S332.
Meyerhoff RR, Yang C-FJ, Speicher PJ et al. Impact of mesothelioma histologic subtype on outcomes in the surveillance, epidemiology, and end results database. J. Surg. Res. 2015; 196; 23-32.
Kadota K, Suzuki K, Colovos C et al. A nuclear grading system is a strong predictor of survival in epitheloid diffuse malignant pleural mesothelioma. Mod. Pathol. 2012; 25; 260-271.
Rosen LE, Karrison T, Ananthanarayanan V et al. Nuclear grade and necrosis predict prognosis in malignant epithelioid pleural mesothelioma: a multi-institutional study. Mod. Pathol. 2018; 31; 598-606.
Habougit C, Trombert-Paviot B, Karpathiou G et al. Histopathologic features predict survival in diffuse pleural malignant mesothelioma on pleural biopsies. Virchows Arch. 2017; 470; 639-646.
Ghanim B, Klikovits T, Hoda M et al. Ki67 index is an independent prognostic factor in epithelioid but not in non-epithelioid malignant pleural mesothelioma: a multicenter study. Br. J. Cancer 2015; 112; 783.
Chapel DB, Churg A, Santoni-Rugiu E, Tsujimura T, Hiroshima K, Husain AN. Molecular pathways and diagnosis in malignant mesothelioma: a review of the 14th international conference of the International Mesothelioma Interest Group. Lung Cancer 2019; 127; 69-75.
Pelosi G, Papotti M, Righi L et al. Pathologic grading of malignant pleural mesothelioma: an evidence-based proposal. J. Thorac. Oncol. 2018; 13; 1750-1761.
Cerruto CA, Brun EA, Chang D, Sugarbaker PH. Prognostic significance of histomorphologic parameters in diffuse malignant peritoneal mesothelioma. Arch. Pathol. Lab. Med. 2006; 130; 1654-1661.
Krasinskas AM, Borczuk AC, Hartman DJ et al. Prognostic significance of morphological growth patterns and mitotic index of epithelioid malignant peritoneal mesothelioma. Histopathology 2016; 68; 729-737.
Postmus P, Kerr K, Oudkerk M et al. Early and locally advanced non-small-cell lung cancer (NSCLC): ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann. Oncol. 2017; 28; iv1-iv21.
Yu Y, Jian H, Shen L, Zhu L, Lu S. Lymph node involvement influenced by lung adenocarcinoma subtypes in tumor size ≤3 cm disease: a study of 2268 cases. Eur. J. Surg. Oncol. 2016; 42; 1714-1719.
Kris MG, Gaspar LE, Chaft JE, Kennedy EB, Azzoli CG, Ellis PM. Adjuvant systemic therapy and adjuvant radiation therapy for stage I to IIIa completely resected non-small-cell lung cancers: American Society of Clinical Oncology/Cancer Care Ontario Clinical Practice Guideline update. J. Clin. Oncol. 2017; 35; 2960-2974.
Gullo I, Carneiro F, Oliveira C, Almeida GMJP. Heterogeneity in gastric cancer: from pure morphology to molecular classifications. Pathobiology 2018; 85; 50-63.
Fernández MI, Williams SB, Willis DL et al. Clinical risk stratification in patients with surgically resectable micropapillary bladder cancer. BJU Int. 2017; 119; 684-691.
Kadota K, Suzuki K, Sima CS, Rusch VW, Adusumilli PS, Travis WD. Pleomorphic epithelioid diffuse malignant pleural mesothelioma: a clinicopathological review and conceptual proposal to reclassify as biphasic or sarcomatoid mesothelioma. J. Thorac. Oncol. 2011; 6; 896-904.
Galateau Salle F, Le Stang N, Nicholson AG et al. New insights on diagnostic reproducibility of biphasic mesotheliomas: a multi-institutional evaluation by the international mesothelioma panel from the mesopath reference center. J. Thorac. Oncol. 2018; 13; 1189-1203.
Alchami FS, Attanoos RL, Bamber AR. Myxoid variant epithelioid pleural mesothelioma defines a favourable prognosis group: an analysis of 191 patients with pleural malignant mesothelioma. J. Clin. Pathol. 2017; 70; 179-182.
Brčić L, Jakopović M, Brčić I et al. Reproducibility of histological subtyping of malignant pleural mesothelioma. Virchows Arch. 2014; 465; 679-685.
Ordóñez NG. Pleomorphic mesothelioma: report of 10 cases. Mod. Pathol. 2012; 25; 1011.
Gutman DA, Khalilia M, Lee S et al. The digital slide archive: a software platform for management, integration, and analysis of histology for cancer research. Cancer Res. 2017; 77; e75-e78.
National Cancer Instititute. The Cancer Genome Atlas. Available at: https://www.cancer.gov/tcga. Date accessed: 22. 07. 2019.
Gao J, Aksoy BA, Dogrusoz U et al. Integrative analysis of complex cancer genomics and clinical profiles using the cbioportal. Sci. Signal. 2013; 6; pl1.
Nicholson AG, Sauter JL, Nowak AK et al. EURACAN/IASLC proposals for updating the histologic classification of pleural mesothelioma: towards a more multidisciplinary approach. J. Thorac. Oncol. 2020; 15; 29-49.
Husain AN, Colby TV, Ordóñez NG et al. Guidelines for pathologic diagnosis of malignant mesothelioma 2017 update of the consensus statement from the international mesothelioma interest group. Arch. Pathol. Lab. Med. 2018; 142; 89-108.
Travis WD, Brambilla E, Nicholson AG et al. The 2015 World Health Organization classification of lung tumors: impact of genetic, clinical and radiologic advances since the 2004 classification. J. Thorac. Oncol. 2015; 10; 1243-1260.
Warth A, Muley T, Meister M et al. The novel Histologic International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society classification system of lung adenocarcinoma is a stage-independent predictor of survival. J. Clin. Oncol. 2012; 30; 1438-1446.
Tsao M-S, Marguet S, Le Teuff G et al. Subtype classification of lung adenocarcinoma predicts benefit from adjuvant chemotherapy in patients undergoing complete resection. J. Clin. Oncol. 2015; 33; 3439.