FDG PET/CT is useful for detecting infiltration to the port site in patients with malignant pleural mesothelioma

• Published in: General thoracic and cardiovascular surgery Vol. 62; no. 3; pp. 157 - 162
• Main Authors: Kawaguchi, Koji, Taniguchi, Tetsuo, Usami, Noriyasu, Fukui, Takayuki, Ishiguro, Futoshi, Nakamura, Shota, Yokoi, Kohei
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.03.2014; Springer Nature B.V
• Subjects: Biopsy; Cardiac Surgery; Cardiology; Chemotherapy; Combined Modality Therapy; Female; Females; Fluorodeoxyglucose F18; Histology; Humans; Lung Neoplasms - diagnostic imaging; Lung Neoplasms - pathology; Lung Neoplasms - surgery; Lymphatic system; Male; Medicine; Medicine & Public Health; Mesothelioma; Mesothelioma - diagnostic imaging; Mesothelioma - pathology; Mesothelioma - surgery; Mesothelioma, Malignant; Metastasis; Middle Aged; Neoplasm Recurrence, Local - diagnostic imaging; Neoplasm Recurrence, Local - surgery; Neoplasm Seeding; Neoplasm Staging; Original Article; Patients; Permits; Pleural Neoplasms - diagnostic imaging; Pleural Neoplasms - pathology; Pleural Neoplasms - surgery; Pneumonectomy; Positron-Emission Tomography; Radiation therapy; Radiopharmaceuticals; Surgeons; Surgical Oncology; Surgical outcomes; Thoracic Surgery; Thoracic Surgery, Video-Assisted; Tomography; Tomography, X-Ray Computed; Tumors; Vascular Access Devices - adverse effects; Port site infiltration; Malignant pleural mesothelioma; FDG PET/CT; Staging
• ISSN: 1863-6705; 1863-6713
• DOI: 10.1007/s11748-013-0345-y

Objective One reason for the poor outcomes of multimodality therapies, including macroscopic complete resection, in patients with malignant pleural mesothelioma (MPM) is the difficulty of correctly staging the disease, which can result in incomplete resection. The purpose of this study was to investigate the aspects of tumor infiltration to the port site and the usefulness of preoperative FDG PET/CT for diagnosing MPM. Methods Between June 2007 and May 2013, 21 patients who underwent surgical treatment with curative intent for MPM that had been previously diagnosed on a video-assisted thoracic surgery (VATS) biopsy were included in this study. Results There were 17 males and four females, with a mean age of 63 years. The accumulation of FDG at the port site was observed in all nine patients with tumor infiltration to the port site, whereas this feature was not noted in 15 patients without tumor extension to the port site. There were more positive lymph node cases in the infiltration group than in the non-infiltration group ( p  = 0.02). No significant differences in survival were observed between the patients with and without tumor infiltration to the port site. Conclusions FDG PET/CT is useful for detecting tumor infiltration of MPM to the port site and may help to prevent local recurrence, especially port site relapse, following macroscopic complete resection. However, this condition is related to tumor aggressiveness; therefore, performing careful staging and determining the appropriate treatment strategy are required in such patients.