Related Experiment Video
Updated: Nov 26, 2025
Implantation and Monitoring by PET/CT of an Orthotopic Model of Human Pleural Mesothelioma in Athymic Mice
Published on: December 21, 2019
Radiological evaluation of malignant pleural mesothelioma - defining distant metastatic disease
Dearbhaile Catherine Collins1, Raghav Sundar1, Anastasia Constantinidou1
1Drug Development Unit, Royal Marsden Hospital/ Institute of Cancer Research, Down Rd, Sutton, SM2 5PT, UK.
Background:
Malignant pleural mesothelioma (MPM) is traditionally characterized by local destructive spread of the pleura and surrounding tissues. Patient outcomes in MPM with distant metastatic dissemination are lacking.
Methods:
In this retrospective study, we reviewed a cohort of 164 MPM patients referred to a Phase I trials unit, aiming to describe identified metastatic sites, and correlate with clinical outcomes.
Results:
67% of patients were diagnosed with distant metastatic disease with a high incidence of bone (19%), visceral (14%), contralateral lung (35%) and peritoneal metastases (22%). Peritoneal metastases were more likely in epithelioid versus biphasic/ sarcomatoid MPM (p = 0.015). Overall survival was 23.8 months with no statistical difference in survival between those with distant metastases and those without.
Conclusions:
This report highlights the frequency of distant metastases and encourages further radiological investigations in the presence of symptoms. In particular, given the relatively high incidence of bone metastases, bone imaging should be considered in advanced MPM clinical workflow and trial protocols. The presence of distant metastases does not appear to have prognostic implications under existing treatment paradigms. This cohort of MPM patients gives an indication of patterns of metastatic spread that are likely to become prevalent as prognosis improves with emerging treatment paradigms.
Insights
Distant metastases are common in malignant pleural mesothelioma (MPM), affecting 67% of patients. However, the presence of these metastases did not impact survival in this study.
Area of Science:
- Oncology
- Pulmonary Medicine
- Pathology
Background:
- Malignant pleural mesothelioma (MPM) typically presents as local disease.
- Data on patient outcomes for MPM with distant metastatic spread is limited.
Purpose of the Study:
- To describe metastatic sites in MPM patients.
- To correlate metastatic sites with clinical outcomes.
- To inform future diagnostic and treatment strategies for MPM.
Main Methods:
- Retrospective analysis of 164 MPM patients.
- Patients were referred to a Phase I trials unit.
- Identification of metastatic sites and correlation with survival.
Main Results:
- 67% of MPM patients had distant metastases.
- Common metastatic sites included bone (19%), visceral (14%), contralateral lung (35%), and peritoneum (22%).
- No significant difference in overall survival was observed between patients with and without distant metastases.
Conclusions:
- Distant metastases are frequent in MPM, warranting further radiological investigation.
- Bone imaging should be considered in advanced MPM protocols due to high incidence of bone metastases.
- Current treatment paradigms suggest distant metastases do not impact survival, but this may change with improved therapies.
