STAGING PERITONEAL MESOTHELIOMA - PERITONEAL MESOTHELIOMA

STAGING PERITONEAL MESOTHELIOMA
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Biopsies are samples of tumor tissue that doctors examine under a microscope in a lab. Medical professionals, called pathologists, perform tests on the biopsy sample to reveal the kinds of cancerous cells within the tumors. They then summarize the results in a pathology report.

Diagnosing Cell Types of Peritoneal Mesothelioma.

The pathology report contains information about which cellular subtype of peritoneal mesothelioma you have.

Common Cell Types.

Epithelioid cells are the most common, making up 75% of cases.
The biphasic type, which is a combination of epithelioid and sarcomatoid cells, is the second most common. It comprises about 25% of cases.

Epithelioid peritoneal mesothelioma can grow in four different patterns: papillary, tubular, diffuse and deciduous. Papillary is the most common and often appears alongside the others.

Pure sarcomatoid tumors are uncommon in peritoneal mesothelioma. Specialists have only diagnosed about 30 cases of this variant since 2006. Sarcomatoid cells usually occur alongside epithelioid cells to form the biphasic subtype.

Rare Cell Types.

Well-differentiated papillary mesothelioma.
Multicystic mesothelioma.
Desmoplastic mesothelioma.
Lymphohistiocytoid mesothelioma.
Pure sarcomatoid mesothelioma.

Additionally, omental mesothelioma is a rare variant that forms in the omentum, a part of the peritoneum surrounding the stomach and other abdominal organs.

Misdiagnosis.

Because this cancer is rare, doctors lacking experience with the disease often misdiagnose abdominal mesothelioma patients with more common illnesses that share similar symptoms. Peritoneal mesothelioma misdiagnosis can delay proper treatment.

If you have a history of asbestos exposure, the best way to ensure an accurate diagnosis is to schedule an appointment with a mesothelioma specialist. Doctors who specialize in peritoneal mesothelioma have the knowledge and tools needed to make a precise diagnosis.

Peritoneal Mesothelioma Staging.

There is no official staging system for peritoneal mesothelioma. Instead, peritoneal mesothelioma experts spent decades adapting other staging systems for their use.

Historically, the TNM staging system used in other cancers has not been a good fit for peritoneal mesothelioma due to the diffuse pattern of growth. However, a research report in 2020 suggested that oncologists could adapt the TNM system for peritoneal mesothelioma into three stages.

3 Stages of Peritoneal Mesothelioma.

Stage 1: Cancerous tissue is minimal, tumors are only within the abdominal lining and lymph nodes are free of cancer.
Stage 2: Cancerous tissue is moderate and tumors have not spread outside the lining or into lymph nodes.
Stage 3: Cancerous tissue is more extensive and tumors may have spread outside the peritoneal lining or into lymph nodes.

There is no precise fourth stage in the adapted TNM system for peritoneal mesothelioma. Many doctors consider stage 4 to involve extensive tumors that have spread to distant sites throughout the body.

Peritoneal Cancer Index.

The Peritoneal Cancer Index is a diagnostic tool that doctors use to assess the location and spread of tumors on the peritoneum. It helps them determine the approximate mesothelioma stage and appropriate treatments.

The index divides the abdomen into 13 parts. Doctors assign a number (one to three) to each area based upon the most sizable tumor in that area. The Peritoneal Cancer Index score is the sum of the individual scores from the 13 regions. A patient’s maximum score is 39 (13 times three).

Lower index scores mean the patient may qualify for surgery. Index scores above 20 indicate cancer has spread too far and that the patient likely won’t respond well to surgery.

Peritoneal Mesothelioma Treatment Options.

The most effective peritoneal mesothelioma treatment option is surgery with heated chemotherapy, also known as hyperthermic intraperitoneal chemotherapy, or HIPEC. However, chemotherapy alone is the most commonly used treatment for peritoneal mesothelioma.

More than 60% of patients are ineligible for surgery with heated chemotherapy due to the procedure’s intensity. Cytoreductive surgery can take several hours and may involve removing large portions of the intestines or whole organs.

STAGING PERITONEAL MESOTHELIOMA - PERITONEAL MESOTHELIOMA
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