Imperial College London
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ProfessorPhilipMolyneaux

Faculty of Medicine, National Heart & Lung Institute

Professor of Interstitial Lung Disease
 
 
 
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p.molyneaux

 
 
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Location

 

Sir Alexander Fleming BuildingSouth Kensington Campus

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Summary

 

Publications

Citation

BibTex format

@article{Zhang:2020:10.1111/his.14127,
author = {Zhang, YZ and Brambilla, C and Molyneaux, PL and Rice, A and Robertus, JL and Jordan, S and Lim, E and Lang-Lazdunski, L and Begum, S and Dusmet, M and Anikin, V and Beddow, E and Finch, J and Asadi, N and Popat, S and Le, Quesne J and Husain, AN and Cookson, WO and Moffatt, MF and Nicholson, AG},
doi = {10.1111/his.14127},
journal = {Histopathology},
pages = {423--436},
title = {Presence of pleomorphic features but not growth patterns improves prognostic stratification of epithelioid malignant pleural mesothelioma by 2-tier nuclear grade},
url = {http://dx.doi.org/10.1111/his.14127},
volume = {77},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - AIMS: Nuclear grade has been recently validated as a powerful prognostic tool in epithelioid malignant pleural mesothelioma (E-MPM). In other studies histological parameters including pleomorphic features and growth patterns were also shown to exert prognostic impact. The primary aims of our study are (1) externally validate the prognostic role of pleomorphic features in E-MPM and (2) investigate if evaluating growth pattern in addition to 2-tier nuclear grade improves prognostication. METHODS AND RESULTS: 614 consecutive cases of E-MPM from our institution over a period of 15 years were retrospectively reviewed, of which 51 showed pleomorphic features. E-MPM with pleomorphic features showed significantly worse overall survival compared those without (5.4 months vs 14.7 months). Tumours with predominantly micropapillary pattern showed the worst survival (6.2 months) followed by solid (10.5 months), microcystic (15.3 months), discohesive (16.1 months), trabecular (17.6 months) and tubulo-papillary (18.6 months). Sub-classification of growth patterns into high grade (solid, micropapillary) and low grade (all others) led to good separation of overall survival (10.5 months vs. 18.0 months) but did not predict survival independent of 2-tier nuclear grade. A composite score comprised of growth pattern and 2-tier nuclear grade did not improve prognostication compared with nuclear grade alone. Intra-tumoural heterogeneity in growth patterns is ubiquitous. CONCLUSIONS: Our findings support the incorporation of E-MPM with pleomorphic features in the epithelioid subtype as a highly aggressive variant distinct from 2-tier nuclear grade. E-MPM demonstrates extensive heterogeneity in growth pattern but its evaluation does not offer additional prognostic utility to 2-tier nuclear grade.
AU  - Zhang,YZ
AU  - Brambilla,C
AU  - Molyneaux,PL
AU  - Rice,A
AU  - Robertus,JL
AU  - Jordan,S
AU  - Lim,E
AU  - Lang-Lazdunski,L
AU  - Begum,S
AU  - Dusmet,M
AU  - Anikin,V
AU  - Beddow,E
AU  - Finch,J
AU  - Asadi,N
AU  - Popat,S
AU  - Le,Quesne J
AU  - Husain,AN
AU  - Cookson,WO
AU  - Moffatt,MF
AU  - Nicholson,AG
DO  - 10.1111/his.14127
EP  - 436
PY  - 2020///
SN  - 0309-0167
SP  - 423
TI  - Presence of pleomorphic features but not growth patterns improves prognostic stratification of epithelioid malignant pleural mesothelioma by 2-tier nuclear grade
T2  - Histopathology
UR  - http://dx.doi.org/10.1111/his.14127
UR  - https://www.ncbi.nlm.nih.gov/pubmed/32333813
UR  - https://onlinelibrary.wiley.com/doi/abs/10.1111/his.14127
UR  - http://hdl.handle.net/10044/1/78978
VL  - 77
ER  -
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