The Prognostic Role of TNM Staging Compared With Tumor Volume and Number of Pleural Sites in Malignant Pleural Mesothelioma

Malignant pleural mesothelioma (MPM) is an aggressive disease with a unique morphology and distribution. Because of its peculiar growth pattern, clinical staging is difficult. Quantitative assessment such as tumor volume (TV) was suggested as an alternative prognostic evaluation. In this study we aimed to compare the prognostic role of Tumor, Node, Metastases (TNM) clinical staging with that of alternative staging approaches on the basis of the use of 2 quantitative clinical parameters, TV and number of pleural sites (NPS), in MPM patients (pts). Our data confirmed the prognostic role of TNM, tumor size, TV, and NPS. However, the TV and NPS combination performed better than TV, NPS, and TNM alone as prognostic classifier. Considering different quantitative parameters and translating such an approach from research level to clinical practice could increase prognostic accuracy for MPM pts, and help clinicians choose the best therapeutic strategy.