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Brain metastases in malignant pleural mesothelioma

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Abstract

The brain is a rare site of metastasis in malignant pleural mesothelioma (MPM), and its clinical features and prognosis remain unclear. The aim of this study was to investigate the incidence, prognosis, and risk factors for brain metastases (BM) in MPM patients. Between July 1993 and October 2014, 150 patients with histologically proven MPM were included in this retrospective study. The cumulative incidence of BM was estimated with the Kaplan–Meier method, and differences between groups were analyzed by the log-rank test. Multivariate logistic regression analysis was applied to assess risk factors for BM. The median follow-up time was 11 months (range 0–154.0 months). A total of eight patients (5.3 %) developed BM during the course of their illness. Multivariate analysis identified age <65 years (odds ratio [OR] = 5.83, p = 0.038) and International Mesothelioma Interest Group stage IV (OR = 1.69, p = 0.040) as independent factors related to increased risk of developing BM. The 1-and 2-year cumulative rates of BM were 4.0 % (95 % confidence intervals [CI] 1.4–8.5 %) and 5.3 % (95 % CI 2.3–10.2 %), respectively. Our study showed that the overall survival (OS) of patients with BM was worse than that of patients without BM (median OS 6.5 vs. 11.0 months, p = 0.037). The prognosis for BM in MPM patients is poor. Clinicians should perform careful screening for BM, especially in patients with risk factors.

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Abbreviations

MPM:

Malignant pleural mesothelioma

BM:

Brain metastasis

ECOG:

Eastern Cooperative Oncology Group

PS:

Performance status

IMIG:

International Mesothelioma Interest Group

EPS:

European Organization for Research and Treatment of Cancer Prognostic Score

CALGB:

Cancer and Leukemia Group B

MRI:

Magnetic resonance imaging

CT:

Computed tomography

OS:

Overall survival

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Acknowledgments

This study was supported by “The research and development and the dissemination projects related to the 9 fields of occupational injuries and illnesses” of the Japan Labour Health and Welfare Organization and by grants-in-aid from the Ministry of Health, Labor and Welfare, Japan (150401-02).

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Authors and Affiliations

  1. Department of Respiratory Medicine, Okayama Rosai Hospital, Okayama, Japan

    Tomoko Yamagishi, Yosuke Miyamoto, Michiko Asano, Yasuko Fuchimoto, Sae Wada, Kenichi Kitamura & Shinji Ozaki

  2. Department of Medical Oncology, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minamiku, Okayama, 702-8055, Japan

    Nobukazu Fujimoto

  3. Department of Surgery, Okayama Rosai Hospital, Okayama, Japan

    Hideyuki Nishi

  4. Department of Internal Medicine, Okayama Rosai Hospital, Okayama, Japan

    Takumi Kishimoto

Authors
  1. Tomoko Yamagishi
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  2. Nobukazu Fujimoto
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  3. Yosuke Miyamoto
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  4. Michiko Asano
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  5. Yasuko Fuchimoto
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  6. Sae Wada
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  7. Kenichi Kitamura
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  8. Shinji Ozaki
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  9. Hideyuki Nishi
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  10. Takumi Kishimoto
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Corresponding author

Correspondence to Nobukazu Fujimoto.

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The authors declare that they have no conflict of interests.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study (retrospective), formal consent is not required.

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Yamagishi, T., Fujimoto, N., Miyamoto, Y. et al. Brain metastases in malignant pleural mesothelioma. Clin Exp Metastasis 33, 231–237 (2016). https://doi.org/10.1007/s10585-015-9772-8

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  • DOI: https://doi.org/10.1007/s10585-015-9772-8

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