High SUVmax on FDG-PET indicates pleomorphic subtype in epithelioid malignant pleural mesothelioma: Supportive evidence to reclassify pleomorphic as nonepithelioid histology Journal Article

   

Authors:	Kadota, K.; Kachala, S. S.; Nitadori, J. I.; Suzuki, K.; Dunphy, M. P. S.; Sima, C. S.; Travis, W. D.; Rusch, V. W.; Adusumilli, P. S.
Article Title:	High SUVmax on FDG-PET indicates pleomorphic subtype in epithelioid malignant pleural mesothelioma: Supportive evidence to reclassify pleomorphic as nonepithelioid histology
Abstract:	BACKGROUND: We have recently proposed to reclassify the pleomorphic subtype of epithelioid malignant pleural mesothelioma (MPM) as nonepithelioid (biphasic/sarcomatoid) histology because of its similarly poor prognosis. We sought to investigate whether preoperative maximum standardized uptake value (SUVmax) on F-fluorodeoxyglucose (FDG) positron emission tomography (PET) correlates with histologic subtype in MPM. METHODS: Clinical data were collected for 78 patients with MPM who underwent preoperative FDG-PET. We retrospectively classified the epithelioid tumors into five subtypes: trabecular, tubulopapillary, micropapillary, solid, and pleomorphic. Tumors were categorized by SUVmax into two groups: low (<10.0) and high (≥10.0). RESULTS: The median overall survival of epithelioid tumors with high SUVmax (n = 12) was significantly shorter (7.1 months) than that of epithelioid tumors with low SUVmax (n = 54, 18.9 months, p < 0.001) and comparable to nonepithelioid tumors (n = 12, 7.2 months). Epithelioid tumors with pleomorphic subtype (n = 9) had marginally higher SUVmax (mean ± SD: 10.6 ± 5.9) than epithelioid nonpleomorphic subtype (n = 57, 6.5 ± 3.2, p = 0.050), and were comparable to that of nonepithelioid tumors (n = 12, 9.1 ± 4.8). Among the epithelioid tumors with high SUVmax (n = 12), 50% (n = 6) showed pleomorphic subtype. In contrast, among epithelioid tumors with low SUVmax (n = 54), 6% (n = 3) showed epithelioid pleomorphic subtypes (p = 0.001). A positive correlation between mitotic count and SUVmax was observed (r = 0.30, p = 0.010). CONCLUSIONS: Pleomorphic subtype of epithelioid MPM showed higher SUVmax than the epithelioid nonpleomorphic subtype and was similar to nonepithelioid histology. Preoperative SUVmax on FDG-PET in epithelioid MPM can indicate patients with pleomorphic subtype with poor prognosis, supporting their reclassification as nonepithelioid. Copyright © 2012 by the International Association for the Study of Lung Cancer.
Keywords:	adult; cancer survival; human tissue; aged; aged, 80 and over; middle aged; survival rate; retrospective studies; overall survival; cancer staging; positron emission tomography; follow-up studies; neoplasm staging; retrospective study; necrosis; histology; cancer invasion; fluorodeoxyglucose f 18; pleura mesothelioma; mesothelioma; sex difference; cancer classification; pleural neoplasms; neoplasms, glandular and epithelial; carcinosarcoma; pleomorphic; pleural neoplasm
Journal Title:	Journal of Thoracic Oncology
Volume:	7
Issue:	7
ISSN:	1556-0864
Publisher:	Elsevier Inc.
Date Published:	2012-07-01
Start Page:	1192
End Page:	1197
Language:	English
DOI:	10.1097/JTO.0b013e3182519d96
PROVIDER:	scopus
PUBMED:	22617244
PMCID:	PMC3691682
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-84862862536&partnerID=40&md5=8e1db45d2ea1629d8c5aaad6a07a8129
Notes:	--- - "Export Date: 1 August 2012" - "Source: Scopus"

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