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Penn Study Shows Lymph Nodes Should Guide Treatment

Joseph S. Friedberg, MD, Chief of the Section of Thoracic Surgery at Penn Presbyterian Medical Center and Co-Director of the Penn Mesothelioma and Pleural Disease Program, gave a presentation at the International Association for the Study of Lung Cancer’s 15th World Conference on Lung Cancer in which he indicated that previously examined lymph nodes located between the ribs were a highly useful diagnostic tool for staging and treating patients with malignant pleural mesothelioma.

The study, one of thirteen that Penn’s mesothelioma team is presenting at the conference, is cause for great excitement among cancer clinicians, because it shows that the presence of cancer cells in lymph nodes that were previously not biopsied can be highly predictive of the patient’s outlook.

Lymph nodes have long been used as an effective diagnostic tool in the staging and treatment of many different types of cancer, but the specific nodes that Penn has been studying, the posterior intercostal lymph nodes, have not been used in the past, and Friedberg says that they are “highly significant.”

The posterior intercostal lymph nodes are located near the spine and are found between the ribs. Though surgical biopsies have included other lymph nodes in the past, Penn’s study broke ground by including these nodes from 48 patients being treated for mesothelioma. The patients were all undergoing radical pleurectomy as part of an aggressive treatment plan for their pleural mesothelioma. Of those patients, more than half had cancer cells present in these lymph nodes, and in some cases those nodes were the only ones that had any metastatic cancer cells at all.

The study showed that the presence of metastatic cancer cells in the posterior intercostal lymph nodes was highly predictive of the patients’ survival rate. Those who had no cancer in the nodes lived two and a half years longer than those who did have the metastatic cancer cells present there.  Because of this Friedburg and his team are suggesting that mesothelioma physicians begin including the biopsy of these nodes in all of their surgically-based treatments, and that they be added to the staging process for all patients.

The conclusion that has been reached as a result of this study is that by using the presence of cancer cells in these particular lymph nodes as a guide, treatment can be adjusted appropriate with great effect and better survival rates for patients.

Terri Oppenheimer

Terri Oppenheimer is an independent writer, editor and proofreader. She graduated from the College of William and Mary with a degree in English. Her dreams of a writing career were diverted by a need to pay her bills. She spent a few years providing copy for a major retailer, then landed a lucrative career in advertising sales. With college bills for all three of her kids paid, she left corporate America for a return to her original goal of writing. She specializes in providing content for websites and finds tremendous enjoyment in the things she learns while doing her research. Her specific areas of interest include health and fitness, medical research, and the law.

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