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Orthotopic Implantation and Peripheral Immune Cell Monitoring in the II-45 Syngeneic Rat Mesothelioma Model
Published on: October 2, 2015
Clinicopathologic Characteristics and Clinical Outcomes of Patients with Testicular Mesothelioma
Prashasti Agrawal1, Fady Baky2, Judy Sarungbam3
1Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.
Background:
Mesothelioma of the tunica vaginalis testes (testicular mesothelioma [TM]) is a rare tumor, comprising less than 5% of mesotheliomas. Surgical intervention is the current standard of care, whereas the role of systemic therapies remains undefined.
Methods:
We retrospectively reviewed 36 patients with pathologically confirmed TM treated at Memorial Sloan Kettering Cancer Center (MSK) between January 1996 to May 2023. Clinicopathologic data, treatments received, and clinical outcomes were reported. Surgical pathology samples, when available, underwent next-generation sequencing (NGS) using MSK-IMPACT. Overall survival (OS) was calculated by using the Kaplan-Meier method.
Results:
Median age at diagnosis was 64 years (range 24-93). Histologically, 22 (61%) tumors were epithelioid, ten (28%) were biphasic, three (8%) were sarcomatoid, and one (3%) was unable to be further classified. Ten patients (28%) had metastatic disease at initial diagnosis, and 13 more (36%) eventually developed metastatic disease. Orchiectomy was performed in 34 (94%) patients and retroperitoneal lymph node dissection (RPLND) in 12 (33%); 15 (42%) received systemic therapy and five (14%) radiation therapy. Ten samples underwent somatic NGS: five (50%) had CDKN2A/B, four (40%) had NF2, and two (20%) had BAP1 alterations. At a median follow up of 3.5 years, median OS was 4.5 years.
Conclusions:
This is the largest single-institution series and genomic dataset for TM. We report unique clinicopathologic and genomic features that distinguish TM from other mesotheliomas, including a lower frequency of BAP1 alterations. Owing to the rarity of this disease, further refinement of the sequence and necessity of surgical and systemic treatment is necessary.
Insights
Testicular mesothelioma (TM) is rare, with surgery as standard care. This study analyzed 36 patients, revealing unique genomic features and a lower frequency of BAP1 alterations compared to other mesotheliomas.
Area of Science:
- Oncology
- Genitourinary Pathology
- Rare Cancers
Background:
- Testicular mesothelioma (TM) is an exceptionally rare malignancy, accounting for less than 5% of all mesothelioma cases.
- Current treatment paradigms primarily rely on surgical intervention, with the efficacy of systemic therapies remaining largely undefined.
Purpose of the Study:
- To characterize the clinicopathologic and genomic features of testicular mesothelioma (TM).
- To evaluate treatment outcomes and survival in patients with TM.
- To compare the genomic landscape of TM with other mesothelioma subtypes.
Main Methods:
- Retrospective review of 36 pathologically confirmed testicular mesothelioma cases treated at a single institution from 1996 to 2023.
- Analysis of clinicopathologic data, treatment modalities (surgery, systemic therapy, radiation), and clinical outcomes.
- Next-generation sequencing (NGS) using MSK-IMPACT on 10 tumor samples to identify somatic alterations.
Main Results:
- The median age at diagnosis was 64 years, with epithelioid histology being the most common (61%).
- 28% of patients presented with metastatic disease, and 36% developed metastases during follow-up.
- Common genetic alterations included CDKN2A/B (50%), NF2 (40%), and BAP1 (20%), with a notably lower frequency of BAP1 alterations compared to other mesotheliomas.
- Median overall survival was 4.5 years.
Conclusions:
- This study represents the largest single-institution series and genomic dataset for testicular mesothelioma (TM).
- TM exhibits distinct clinicopathologic and genomic profiles, including a lower incidence of BAP1 alterations.
- Further research is warranted to optimize treatment strategies, including the role of systemic therapy, for this rare malignancy.
