Maryland Researchers have found that lymph nodes between the chest area and spine of malignant pleural mesothelioma patients are an exceedingly significant indicator of mesothelioma cancer prognosis.

This discovery could radically alter the diagnosis of the accurate staging of pleural mesothelioma. With an improved and early prognosis of this life-threatening disease, doctors will be able to recommend life-saving treatment options to the patients, increasing survival time.

A team of researchers at the University of Maryland School of Medicine, led by Dr. Joseph Friedberg determined that lymph node status can be an excellent indicator to check the prognosis of malignant mesothelioma.

Malignant pleural mesothelioma (MPM) is challenging to diagnose and treat cancer. MPM is caused by exposure of asbestos through inhalation or indigestion. Around 3000, patients are diagnosed with malignant pleural mesothelioma in the United States annually.

MPM patients who are treated by doctors with only chemotherapy as the standard model of care have a survival time of 12 to 18 months on average. The researchers from all around the world are searching for new and improved ways to diagnose and treat this disease.

The staging of mesothelioma is used to find out how advanced and metastasized the tumor is. It is imperative as it acts as a deciding factor for the treatment.

Lymph Node Status Can Provide Information For Mesothelioma Staging

The prognosis of mesothelioma can be beneficial for the doctors in determining the treatment options for the patients. According to staging research, the posterior intercostal lymph nodes (which function to drain the area between the ribs) are overlooked by current procedures during the staging of mesothelioma.

Mediastinal lymph nodes are looked to check the presence of mesothelioma tumor cells. Mediastinal lymph nodes are between the sternum and the spinal column (the mediastinum region).

Dr. Joseph Friedberg, a notable mesothelioma expert, director of the Mesothelioma Thoracic Oncology Treatment and Research Center, and the lead investigator of this research said that,

"Although larger studies are needed, we believe that these lymph nodes should routinely be removed during any surgery with therapeutic intent for malignant pleural mesothelioma, especially as they may be the only lymph nodes to harbor metastatic disease.”

In the experimental design of this research, 56 pleural mesothelioma patients were studies who underwent lung-sparing surgery. In addition to removing the diseased part, the surgeons also removed the posterior intercostal lymph nodes.

Researchers found that in lymph nodes of 48% of the pleural mesothelioma patients mesothelioma cells were present. Interestingly, 7% of the patients had metastasized mesothelioma cells only in the posterior intercostal lymph nodes, which are usually neither considered during the staging of the mesothelioma nor during the surgery.

These results showed that without considering lymph nodes, topping the metastasis of mesothelioma is impossible, no matter how advanced the surgical treatment is.

Double Risk of Death With Tumor in Lymph Nodes

Researchers shared startling information regarding the presence of mesothelioma cells in the lymph nodes of patients. They found that cancer cells in the posterior intercostal lymph nodes elevate the chances of mesothelioma recurrence or death by two times in patients undergoing surgical treatment.

The above findings enhance the importance of lymph nodal analysis more. If doctors overlook this part of the body, no surgical treatment can have real survival chances.

The Need to Further Investigate and Research Lymph Node Status In Prognosis of Mesothelioma

Dr. Joseph Friedberg pointed out that advanced research is required to further verify the importance of lymph nodes in the prognosis of pleural mesothelioma. He said,

"These nodes warrant further investigation, including non-operative techniques to identify them and factor them into treatment decision-making."

Acknowledging the experimental design and encouraging results of this research, E. Albert Reece, Dean University of Maryland School of Medicine said,

"Malignant pleural mesothelioma is a very difficult cancer to treat, and Dr. Friedberg's research advances our ability to understand how we might incorporate these newly-identified lymph nodes into better staging and treatment for our patients"


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