Dienemann, Hendrik

Herth, Felix J.

Hoffmann, Hans

Meister, Michael A.

Muley, Thomas R.

Philipp, Monika

Schneider, Joachim

Elsevier - Publisher Connector 

Journal of Thoracic Oncology • Volume 2, Number 8, Supplement 4, August 2007  12th World Conference on Lung Cancer
Copyright © 2007 by the International Association for the Study of Lung CancerS608
Special thanks to dr Benfante,dr Bergaglio and dr Tunesi.
P1-143 Mesothelioma and Other Thoracic Malignancy Posters, Mon, Sept 3 
Surgical Resection for Oral Tongue Cancer Pulmonary Metastases, 
a Good Choice?
Mochizuki, Takahiro1 Okumura, Sakae2 Yoshida, Junji1 Ishii, 
Genichiro3 Ishikawa, Yuichi4 Hayashi, Ryuichi5 Kawabata, Kazuyoshi6 
Nakagawa, Ken2 Nagai, Kanji1 
1 Division of Thoracic Surgery, Department of Thoracic Oncology, 
National Cancer Center Hospital East, Kashiwa, Japan 2 Department 
of Thoracic Surgical Oncology, Cancer Institute Hospital, Japanese 
Foundation for Cancer Research, Koto, Japan 3 Pathology Division, 
Research Center for Innovative Oncology, National Cancer Center 
Hospital East, Kashiwa, Japan 4 Department of Pathology, Cancer 
Institute, Japanese Foundation for Cancer Research, Koto, Japan 5 
Division of Head and Neck Surgery, National Cancer Center Hospital 
East, Kashiwa, Japan 6 Department of Head and Neck, Cancer Institute 
Hospital, Japanese Foundation for Cancer Research, Koto, Japan 
Background: The lung is the most common distant metastasis site 
from oral tongue cancer (OTC). However, there have been no reports 
on surgical resection results for pulmonary OTC metastases. The aim 
of this study was to evaluate surgical resection for OTC pulmonary 
metastases efﬁcacy. 
Methods: Between 1977 and 2003, 23 OTC patients who developed 
1 to 3 pulmonary metastases underwent metastasectomy. The clinico-
pathologic features and long-term outcomes were examined. 
Results: The 14 men and 9 women had a median age at the time of pul-
monary metastasectomy of 56 (range; 28-72 years). All 23 patients had 
advanced squamous cell OTC with regional lymph node involvement 
or subsequent regional lymph node metastasis. The median tumor-free 
interval after the initial OTC treatment was 17 months (range: 1-165 
months). Five patients had pneumonectomy, three bilobectomy, 13 
lobectomy, and two wedge resection. Two patients underwent a second 
pulmonary metastasectomy. One patient continues to survive, without 
recurrence at 229 months right now. Twenty-two patients developed 
systemic metastases. The interval to systemic metastasis recurrence 
after pulmonary resection ranged from 1 to 17 months (median, 3.5 
months) and 21 died of OTC at 9.5 months median (range: 1-26 
months) after metastasectomy. One patient was alive with disease at 24 
months after metastasectomy but was lost to follow-up.
Conclusions: Most patients who had OTC pulmonary metastasectomy 
died of the disease within two years. Even for patients with a solitary 
metastasis, surgical resection for OTC pulmonary metastases is not a 
recommended treatment option.
P1-144 Mesothelioma and Other Thoracic Malignancy Posters, Mon, Sept 3 
Soluble Mesothelin related Proteins in Patients with Malignant 
Pleural Mesothelioma in Comparison to Asbestos Diseases and 
Lung Cancer
Muley, Thomas R.1 Meister, Michael A.1 Hoffmann, Hans2 Dienemann, 
Hendrik2 Herth, Felix J.3 Philipp, Monika4 Schneider, Joachim4 
1 Translational Research Unit, Thoraxklinik am Universitätsklinikum 
Heidelberg, Heidelberg, Germany 2 Dept. of Surgery, Thoraxklinik 
am Universitätsklinikum Heidelberg, Heidelberg, Germany 3 Dept. of 
Pneumology, Thoraxklinik am Universitätsklinikum Heidelberg, Heidel-
berg, Germany 4 Institut und Poliklinik für Arbeits- und Sozialmedizin, 
University of Giessen, Giessen, Germany 
Background: Soluble mesothelin related proteins (SMRP) have been 
reported as being potential markers for the detection, staging and 
monitoring of treatment of malignant pleural mesothelioma (MPM). In 
order to evaluate the diagnostic accuracy, i.e. sensitivity and speciﬁcity 
of a new ELISA test, we investigated SMRP serum concentrations in 
patients with MPM, primary lung cancer and benign asbestos diseases, 
with a particular focus on differential diagnosis. 
Methods: The study population consisted of 100 newly diagnosed 
MPM patients. They were compared to 75 patients with severe forms 
of asbestosis and 139 patients suffering from untreated primary lung 
cancer. In addition, 29 MPM patient with tumor relapse or progres-
sion after initial therapy were included. SMRP serum concentrations 
were measured by using the newly developed ELISA kit Mesomark™ 
(Fujirebio Diagnostics, Malvern, USA distributed by CIS bio GmbH, 
Berlin, Germany). Statistical analyses (Mann-Whitney U-Test, ROC 
analysis) were performed with SPSS 14.0 (Chicago, Illinois, USA).
Results: SMRP concentrations were found to be signiﬁcantly higher 
in patients suffering from MPM in comparison to benign asbestos dis-
eases (p<0.001) or primary lung cancer (p<0.001). The median values 
(range) were 1.4 (0.2-31.0) nM, 0.9 (0.1-3.3) nM and 0.8 (0-6.0) nM 
respectively. The highest SMRP concentrations were found in patients 
with the epithelial subtype of MPM. However, this was not signiﬁ-
cantly different from the serum concentrations of the sarcomatoid and 
the biphasic subtypes. SMRP tended to increase with the tumour stages 
of MPM. 
At a cutoff value of 1.6 nM SMRP reached a sensitivity of 42% with a 
speciﬁcity of 95% for benign asbestos diseases. Youden index revealed 
an optimal cutoff value of 1.35 nM resulting in a sensitivity of 53% and 
a speciﬁcity of 88%. However, SMRP were also increased in 12.9% 
(cut-off 1.6 nM) or 19.9% (cutoff 1.35nM) of lung cancer patients. 
Receiver operator characteristics (ROC) curves resulted in an area 
under curve (AUC) of 0.72 (95%CI:0.66-0.79) for the discrimination 
between MPM and non-MPM patients (lung cancer and asbestosis). In 
the 29 MPM patients with relapse/progression after an initial therapy, 
SMRP levels were found to be signiﬁcantly higher (Median: 4.2 (0.2-
51.0) nM; p<0.001) compared to the 100 MPM patients without prior 
treatment.
Conclusion: SMRP serum concentration might be an useful measure 
in the diagnostic characterisation of MPM and for the differentiation 
between MPM, benign asbestosis and lung cancer patients. In addition, 
our results indicate that SMRP might be useful in treatment monitoring 
and follow-up. 
P1-145 Mesothelioma and Other Thoracic Malignancy Posters, Mon, Sept 3 
Predictors of “long term” survival following surgical treatment of 
malignant pleural effusion
Pilling, John; Dusmet, Michael; Ladas, George; Goldstraw, Peter 
Royal Brompton Hospital, London, UK
Objective: To investigate prognostic factors following surgical pallia-
tion of malignant pleural effusion (MPE).
Method: We reviewed 280 consecutive patients [109 male, median age 
60 years (range 26 - 89)] undergoing 312 surgical procedures for pallia-
tion of MPE over 72 months. The commonest malignancies were breast 
(29%), malignant pleural mesothelioma (MPM) (25%), lung (12%), 
ovary (9%) and adenocarcinoma of unknown primary (5%). There 


P1-144: Soluble Mesothelin related Proteins in Patients with Malignant Pleural Mesothelioma in Comparison to Asbestos Diseases and Lung Cancer 

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P1-144: Soluble Mesothelin related Proteins in Patients with Malignant Pleural Mesothelioma in Comparison to Asbestos Diseases and Lung Cancer

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