Nervous system metastases from malignant mesothelioma

Our plain-English summary of Nervous system metastases from malignant mesothelioma, by N.M. Martinez, I.T. Gavrilovic, C. Grommes (Clinical Oncology, 2013).

The study

• Authors: N.M. Martinez, I.T. Gavrilovic, C. Grommes
• Journal: Clinical Oncology
• Published: 2013;25(1):74
• Type of article: Letter
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

In plain English

This short letter described a retrospective review of patients with malignant mesothelioma whose cancer had spread to the nervous system. The patients were treated at Memorial Sloan-Kettering Cancer Center in New York, and the authors compared them with 54 cases published between 1924 and 2010. Of 1408 patients with malignant mesothelioma at the center, eight had nervous system metastases: five in the brain (0.35%) and three with epidural disease (0.21%). Median age at diagnosis of the metastases was 66 at the center and 56 in the published cases. Median time to nervous system metastases was 297 days at the center and 180 days in published cases. Median survival after that diagnosis was 192 and 90 days, respectively. For brain metastases, patients given best supportive care survived a median of 50 days (center) and 60 days (published cases), compared with 210 and 90 days for patients given any treatment. The authors concluded that any treatment, particularly combined modality therapy, is associated with longer survival after nervous system metastases. The center's figures came from eight patients. The letter did not discuss asbestos exposure.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Retrospective single-institution case series, published as a letter, compared with cases previously reported in the medical literature
• Who was studied: 1408 patients with malignant mesothelioma at Memorial Sloan-Kettering Cancer Center, New York, of whom 8 had nervous system metastases (years not stated). These were compared with 54 published cases from 1924 to 2010 (38 brain, 13 spine, three leptomeningeal disease).
• Main results:
  • At the center, 8 of 1408 patients with malignant mesothelioma had nervous system metastases: brain in five (0.35%) and epidural disease in three (0.21%).
  • 54 cases were found in the literature from 1924 to 2010: 38 brain, 13 spine, three leptomeningeal disease.
  • Median age at diagnosis of nervous system metastases was 66 at the center and 56 years in the published cases.
  • Median time to nervous system metastases was 297 days (center) and 180 days (published cases). For brain it was 249 and 168 days. For epidural disease it was 1195 and 210 days.
  • Median overall survival after diagnosis of nervous system metastases was 192 days (center) and 90 days (published cases). For brain it was 183 and 83 days. For epidural disease it was 360 and 75 days.
  • After diagnosis of brain metastases, median survival with best supportive care was 50 days (center) and 60 days (published cases). With treatment of any kind it was 210 and 90 days.
  • The authors suggested that spinal metastases may arise by direct extension from bone or paraspinal masses, which may explain the longer survival of the center's patients with epidural involvement.
• The authors' conclusion: The authors concluded that their series and the published cases suggest any treatment, especially combined modality therapy, is associated with prolonged survival after diagnosis of nervous system metastases.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma.

Related studies

• Malignant mesothelioma and central nervous system metastases. Report of two cases, pooled analysis, and systematic review — A.C. Miller, M. Miettinen, et al. (2014)
• Malignant mesothelioma with bone metastases — W.F. Cheng, A.W. Berkman (1990)
• Brain metastases in malignant pleural mesothelioma — T. Yamagishi, N. Fujimoto, et al. (2016)
• Malignant mesothelioma with brain metastases — J.A. Kaye, A.M. Wang, et al. (1986)
• Brain metastases in malignant pleural mesothelioma. Case report and review of the literature — K.S. Sridhar, A.M. Hussein, et al. (1989)
• Response to chemotherapy of brain metastases from malignant pleural mesothelioma — M. Colleoni, G. Liessi, et al. (1996)

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