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Background <p>Malignant pleural mesothelioma (MPM) is an aggressive usually asbestos-associated tumor of the pleura with an unfavorable prognosis. In Germany 1243 new cases were registered in 2022, the&#xa0;5-year survival rate is 8% for men and 14% for women.</p> Objective <p>Are there current findings and recommendations on the diagnosis and treatment of MPM?</p> Material and methods <p>A summary and comparative description of current international guidelines on MPM and the 9th&#xa0;edition of the UICC are presented.</p> Results <p>The 9th&#xa0;edition of the TNM classification (valid from 2026) integrates quantitative computed tomography (CT)-based criteria, such as the sum of maximum pleural thicknesses (Psum) and maximum fissure thickness (Fmax) for a better differentiation between T1 and T3 stages. The T4 definition remains unchanged. The M and&#xa0;N categories have been retained but show relevant prognostic differences. Basic staging includes a&#xa0;thorax/abdomen CT and, depending on the planned treatment concept, should be extended to include positron emission tomography (PET)-CT and invasive mediastinal staging, especially in cases of planned multimodal treatment. The management of MPM includes best supportive care, systemic treatment or immunotherapy, multimodal concepts with platinum-based combination chemotherapy, local treatment methods and selectively also radiotherapy.</p> Discussion <p>The integration of objective size parameters enables standardized radiological evaluation, improves prognostic significance and underscores the importance of an individualized, stage-adapted treatment of MPM. Treatment concepts are becoming increasingly more differentiated, ranging from immuno-oncological combinations to multimodal concepts in selected cases and innovative local treatment methods.</p>

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Pleuramesotheliom – Diagnostik und Therapie

  • 期刊论文

  • 发表日期：

    2025年10月22日

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  • Julia Riedel,
  • Christopher Larisch,
  • Clemens Wiest,
  • Christian Schulz,
  • Christoph Süß,
  • Hans-Stefan Hofmann,
  • Michael Ried

摘要

Background

Malignant pleural mesothelioma (MPM) is an aggressive usually asbestos-associated tumor of the pleura with an unfavorable prognosis. In Germany 1243 new cases were registered in 2022, the 5-year survival rate is 8% for men and 14% for women.

Objective

Are there current findings and recommendations on the diagnosis and treatment of MPM?

Material and methods

A summary and comparative description of current international guidelines on MPM and the 9th edition of the UICC are presented.

Results

The 9th edition of the TNM classification (valid from 2026) integrates quantitative computed tomography (CT)-based criteria, such as the sum of maximum pleural thicknesses (Psum) and maximum fissure thickness (Fmax) for a better differentiation between T1 and T3 stages. The T4 definition remains unchanged. The M and N categories have been retained but show relevant prognostic differences. Basic staging includes a thorax/abdomen CT and, depending on the planned treatment concept, should be extended to include positron emission tomography (PET)-CT and invasive mediastinal staging, especially in cases of planned multimodal treatment. The management of MPM includes best supportive care, systemic treatment or immunotherapy, multimodal concepts with platinum-based combination chemotherapy, local treatment methods and selectively also radiotherapy.

Discussion

The integration of objective size parameters enables standardized radiological evaluation, improves prognostic significance and underscores the importance of an individualized, stage-adapted treatment of MPM. Treatment concepts are becoming increasingly more differentiated, ranging from immuno-oncological combinations to multimodal concepts in selected cases and innovative local treatment methods.