Among these patients with positive posterior intercostal lymph nodes, median overall survival was significantly shorter than among patients with no cancer in these nodes.
Raleigh, NC (PRWEB) November 12, 2013
According research presented at the 15th World Conference on Lung Cancer and detailed on Surviving Mesothelioma, scientists at the University of Pennsylvania have found that a set of lymph nodes that are usually ignored could help predict mesothelioma outlook and guide treatment planning.
The posterior intercostal lymph nodes are located between the ribs near the spine. Until now, they have not been routinely tested to see whether mesothelioma or another type of cancer has spread. But Dr. Joseph Friedberg and his colleagues at the University of Pennsylvania’s Penn Mesothelioma and Pleural Disease Program found that these nodes should not be disregarded, especially in mesothelioma patients.
The team tested these nodes for the presence of cancer cells in 48 patients who were undergoing surgery for malignant pleural mesothelioma. They found that mesothelioma had spread to these nodes in 54% of cases and that, among these patients with positive posterior intercostal lymph nodes, median overall survival was significantly shorter than among patients with no cancer in these nodes. This held true even in patients whose other tested lymph nodes – the ones typically used for cancer staging – were free of metastatic mesothelioma cells.
Patients with positive posterior intercostal lymph nodes had a median progression-free survival period of 0.73 years, or just under 9 months. For those with negative posterior intercostal lymph nodes, median progression-free survival was a year and 3 months. Further, overall survival in the mesothelioma patients with negative nodes was also much better – 3.43 years vs. 1.01 years in those with positive posterior intercostal lymph nodes.
Although the study had some limitations, including short follow-up time, Friedberg and his colleagues say it indicates that posterior intercostal lymph nodes may have “independent prognostic significance” and should be routinely biopsied as part of mesothelioma surgery. If further studies support these findings, these obscure lymph nodes may eventually become a regular part of mesothelioma staging.
The findings were originally presented at the International Association for the Study of Lung Cancer’s 15th World Conference on Lung Cancer recently held in Sydney, Australia. (Friedberg, Joseph, et al, “Posterior intercostal lymph nodes – First report of a new independent prognostic factor for malignant pleural mesothelioma”, October 28, 2013, Mini Oral Abstract Session, IASLC 15th World Conference on Lung Cancer, Abstract number M009.12. http://abstracts.webges.com/wclc2013/myitinerary)
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