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Measuring Malignant Pleural Mesothelioma

A. Nowak, S. Armato
Published 2019 · Medicine

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Measurement of malignant pleural mesothelioma poses significant challenges, but tumor measurement is important for clinical trials and patient prognostication. While anatomical T staging of mesothelioma currently incorporates only the extent of tumor invasion into adjacent structures, tumor burden is emerging as potentially important in this context and is the subject of current research. Assessment of the rate of change, or growth, of mesothelioma is not commonly used in clinical research, but this parameter is often informally considered in clinical practice; future research may reveal rate of tumor growth as a potentially informative prognostic indicator. Finally, the most common role for the measurement of mesothelioma is the assessment of treatment response, either in routine clinical practice or in clinical trials. Modified RECIST (mRECIST) for mesothelioma developed a process for measuring mesothelioma that is more appropriate for the unique growth pattern of this tumor, involving measurement of tumor thickness perpendicular to the chest wall or mediastinum. This process has recently been updated as mRECIST 1.1 to incorporate results of new research and to align with RECIST 1.1; mRECIST 1.1 should be used for the next generation of clinical trials in this disease.
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