To seed or not to seed: the open question of mesothelioma intervention tract metastases

Our plain-English summary of To seed or not to seed: the open question of mesothelioma intervention tract metastases, by L. Bertolaccini, A. Viti, A. Terzi (Chest, 2014).

The study

• Authors: L. Bertolaccini, A. Viti, A. Terzi
• Journal: Chest
• Published: 2014;146(3):e111
• Type of article: Letter, Comment
• Cited by: 8 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

This letter to the editor commented on a study by Thomas et al., published in the same issue of CHEST, of catheter tract metastasis (CTM) after insertion of indwelling pleural catheters (IPCs). The authors noted that tract seeding is a common complication of diagnostic and therapeutic procedures for mesothelioma pleural effusion, but that there are few reports of CTM after IPC insertion. They cited a pooled systematic review of 10 studies involving 1,093 patients, in which nine patients (0.8%) had catheter tract seeding. In their own earlier study, they had found no cases of CTM in 13 of 90 patients with mesothelioma pleural effusions treated with IPC placement. They said the available literature lacks information on histologic subtype, disease stage, and treatment or diagnostic procedure. They summarized Thomas et al.: IPCs were placed mainly for mesothelioma-related effusion (60%), 10% of patients developed CTM (nine of the 11 with tract seeding had mesothelioma), and of the patients referred for radiotherapy, six completed it and four had a clinical response. The authors stated that the benefit of prophylactic tract irradiation in mesothelioma remains controversial. The two randomized trials were small and underpowered, and such irradiation has not been tested in patients with IPCs. They concluded that it will need to be tested in this group.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This is a letter to the editor of the journal Chest, written in reply to a study by Thomas and colleagues in the same issue. It reports no new research. The authors noted that few reports describe catheter tract metastasis, meaning tumor growing along the path of the tube, after insertion of an indwelling pleural catheter (IPC). They cited a pooled review of 10 studies covering 1,093 patients, in which nine patients (0.8%) had tract seeding. They also cited their own earlier study, writing that they found no cases in 13 of 90 patients with mesothelioma pleural effusions. They summarized Thomas and colleagues as reporting that 10% of patients developed such metastasis, nine of the 11 affected having mesothelioma. Of the patients referred for radiotherapy, six completed it and four responded. The authors described the two randomized trials of preventive radiation as small. They concluded that preventive radiation needs to be tested in IPC patients. A partial reply from the series' authors reported metastasis after nine of 66 IPCs (13.6%) placed in mesothelioma patients.

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: Letter to the editor (correspondence) commenting on another study; no new data
• Who was studied: No patients were studied. The letter discusses published reports on patients with mesothelioma pleural effusion treated with indwelling pleural catheters.
• Exposure: Not asbestos exposure. The letter concerns insertion of indwelling pleural catheters (IPCs) in patients with mesothelioma pleural effusion.
• Main results:
  • The letter cites a pooled systematic review by other researchers: 10 studies, 1,093 patients, catheter tract seeding in nine patients (0.8%).
  • The authors cite their own earlier study, wording the finding as no cases of catheter tract metastasis in 13 of 90 patients with mesothelioma pleural effusions treated with IPC.
  • The letter summarizes Thomas et al: 10% of patients developed catheter tract metastasis, and nine of the 11 with tract seeding had mesothelioma.
  • According to the letter's summary of Thomas et al, among patients with catheter tract metastasis referred for radiotherapy, six completed therapy and four had a clinical response.
  • The authors state that preventive irradiation of the intervention tract has not been tested in patients with IPC.
  • The partial reply from the authors of the Thomas series reports catheter tract metastasis in nine of 66 IPCs (13.6%) placed in mesothelioma patients.
• The authors' conclusion: The authors concluded that preventive irradiation of the intervention site will need to be tested to see whether it can reduce or prevent tract colonization in patients with an IPC.
• Limitations the authors state:
  • The authors state that the available literature lacks information on histologic subtype, disease stage, and the treatment or diagnostic procedure used.
  • The authors state that the two randomized trials of preventive tract irradiation were small and lacked statistical power.

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Tract Metastasis, Indwelling Pleural Catheter, Pleural Effusion, Systematic Review, Histological Subtype, Prophylactic Tract Irradiation.

Related studies

• Catheter tract metastasis associated with indwelling pleural catheters — R. Thomas, C.A. Budgeon, et al. (2014)
• Response — R. Thomas, Y.C.G. Lee (2014)
• Aggressive versus symptom-guided drainage of malignant pleural effusion via indwelling pleural catheters (AMPLE-2): an open-label randomised trial — S. Muruganandan, M. Azzopardi, et al. (2018)
• Catheter Tract Metastasis in Mesothelioma Patients with Indwelling Pleural Catheters: A Retrospective Cohort Study — M.A. Mitchell, P. Li, et al. (2019)
• Tumor extension along chest wall tract after diagnostic intervention in malignant pleural mesothelioma — F. Chen, A. Yoshizawa, et al. (2011)
• Prophylactic radiotherapy for the prevention of procedure-tract metastases after surgical and large-bore pleural procedures in malignant pleural mesothelioma (SMART): a multicentre, open-label, phase 3, randomised controlled trial — A.O. Clive, H. Taylor, et al. (2016)

Browse more research in Chest, or return to medical research.