Your doctor wants to be able to give you an accurate prognosis for survival after you’re diagnosed with or treated for mesothelioma.
There are a number of approaches doctors can use for making mesothelioma prognoses. Some of these approaches are more accurate than others. But all are pretty good.
The problem is that most of the approaches work only if you have malignant pleural mesothelioma. The approaches that work if you have diffuse malignant peritoneal mesothelioma are far fewer.
Researchers from three cancer treatment centers joined forces a while back to develop an additional approach just for peritoneal mesothelioma.
Epithelioid Peritoneal Mesothelioma Grading System
Their new approach is a histomorphologic grading system. What that means is that lab techs will take a sample of mesothelioma cells from your abdomen and then do two things.
First, they’ll analyze how those tissues are structured. That’s called histology. Then, they’ll look at how those tissues form. That’s called morphology. Put the two together and you’ve got histomorphology.
Working up a histomorphology requires the lab techs to focus on structures and processes at the very heart of the sampled peritoneal mesothelioma cells. In other words, their eyes must be trained on the cell nucleus.
Nuclear analysis lets them grade the mesothelioma tissues they examine. This new approach has only two grades — high or low. But those grades are sufficient to predict your mesothelioma survival.
The researchers are from Wake Forest Baptist Health in Winston-Salem, North Carolina, University of Mississippi Medical Center in Jackson, Mississippi, and Memorial Sloan Kettering Cancer Center in New York City.
Their nuclear grading system was discussed in an article they wrote for The American Journal of Surgical Pathology.
The title of that article is “A Histomorphologic Grading System That Predicts Overall Survival in Diffuse Malignant Peritoneal Mesothelioma With Epithelioid Subtype.”
The researchers said their grading system is valid only for the epithelioid type of peritoneal mesothelioma. But that’s okay. Most peritoneal mesothelioma patients will be likely to benefit from this new grading system since the epithelioid type is the most common.
Peritoneal Mesothelioma Patient Data Studied
To develop the grading system, the researchers evaluated records of 51 patients who suffered from diffuse malignant peritoneal mesothelioma.
Clinical data on each of these patients had been kept by Wake Forest Baptist Health. The oldest records dated back to 1984. The most recent dated to 2013.
All of the patients had undergone cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy as their first-line treatment.
From those records, the researchers were able to identify 46 patients whose peritoneal mesothelioma was of the epithelioid type.
The records provided enough lab data on each patient to let the researchers put their new grading system to the test.
From this testing they observed that patients whose mesothelioma was graded low had better overall survival than those whose mesothelioma was graded high.
The median survival of patients with peritoneal mesothelioma receiving a low grade was 11.9 years. But the median survival of those with mesothelioma receiving a high grade was just 3.3 years.
The researchers said they would like to conduct more studies into the potential usefulness of this grading system.
