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Katz SI, Straus CM, Roshkovan L, Blyth KG, Frauenfelder T, Gill RR, Lalezari F, Erasmus J, Nowak AK, Gerbaudo VH, Francis RJ, Armato SG. Considerations for Imaging of Malignant Pleural Mesothelioma: A Consensus Statement from the International Mesothelioma Interest Group. J Thorac Oncol 2023; 18:278-298. [PMID: 36549385 DOI: 10.1016/j.jtho.2022.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 11/13/2022] [Accepted: 11/17/2022] [Indexed: 12/24/2022]
Abstract
Malignant pleural mesothelioma (MPM) is an aggressive primary malignancy of the pleura that presents unique radiologic challenges with regard to accurate and reproducible assessment of disease extent at staging and follow-up imaging. By optimizing and harmonizing technical approaches to imaging MPM, the best quality imaging can be achieved for individual patient care, clinical trials, and imaging research. This consensus statement represents agreement on harmonized, standard practices for routine multimodality imaging of MPM, including radiography, computed tomography, 18F-2-deoxy-D-glucose positron emission tomography, and magnetic resonance imaging, by an international panel of experts in the field of pleural imaging assembled by the International Mesothelioma Interest Group. In addition, modality-specific technical considerations and future directions are discussed. A bulleted summary of all technical recommendations is provided.
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Affiliation(s)
- Sharyn I Katz
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
| | - Christopher M Straus
- Department of Radiology, University of Chicago Pritzker School of Medicine, Chicago, Illinois
| | - Leonid Roshkovan
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Kevin G Blyth
- Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Thomas Frauenfelder
- Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Ritu R Gill
- Department of Radiology, Beth Israel Lahey Health, Harvard Medical School, Boston, Massachusetts
| | - Ferry Lalezari
- Department of Radiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Jeremy Erasmus
- Department of Radiology, MD Anderson Cancer Center, Houston, Texas
| | - Anna K Nowak
- Medical School, University of Western Australia, Perth, Australia
| | - Victor H Gerbaudo
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Roslyn J Francis
- Medical School, University of Western Australia, Perth, Australia; Department of Nuclear Medicine, Sir Charles Gairdner Hospital, Perth, Australia
| | - Samuel G Armato
- Department of Radiology, University of Chicago Pritzker School of Medicine, Chicago, Illinois
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Wang Y, Xu Y, Kan Y, Wang W, Yang J. Prognostic value of 18F-FDG PET/CT in malignant pleural mesothelioma: a meta-analysis. Acta Radiol 2023; 64:552-562. [PMID: 35315714 DOI: 10.1177/02841851221085378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Several FDG PET/CT parameters have been utilized to evaluate the prognosis in malignant pleural mesothelioma (MPM). However, there are still controversial results due to the low incidence of MPM. PURPOSE To assess the prognostic value of 18F-FDG PET/CT in MPM. MATERIAL AND METHODS A systematic literature search was performed in PubMed, Embase, Medline, and The Cochrane Library to identify eligible studies from inception to 12 February 2020. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) of several variables, such as maximum standardized uptake value (SUVmax), the reduction of SUVmax after treatment (ΔSUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and the reduction of TLG after treatment (ΔTLG), were calculated. Meta-regression with subsequent subgroup analyses were conducted to determine the heterogeneity of cutoff values, treatment regimen, study design, uptake time, and scanners across various studies. RESULTS In total, 19 eligible studies including 1819 patients were enrolled in the meta-analysis. The univariate analysis showed that the pooled HRs (95% CI) of SUVmax, ΔSUVmax, MTV, TLG, and ΔTLG were 1.29 (1.16-1.42), 1.12 (1.05-1.19), 1.15 (1.00-1.33), 1.47 (1.23-1.76), and 1.27 (1.12-1.45), respectively. The multivariate analysis showed that the pooled HRs (95% CI) of SUVmax, ΔSUVmax, MTV, and TLG for overall survival (OS) were 1.20 (1.08-1.33), 1.10 (1.02-1.19), 0.95 (0.81-1.11), and 1.13 (1.08-1.18), respectively. CONCLUSION SUVmax, ΔSUVmax, TLG, and ΔTLG are significant prognostic indicators for OS, while more clinical studies are needed to confirm the prognostic value of MTV in MPM.
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Affiliation(s)
- Yu Wang
- Department of Nuclear Medicine, 26455Beijing Friendship Hospital of Capital Medical University, Beijing, PR China
| | - Yanfeng Xu
- Department of Nuclear Medicine, 26455Beijing Friendship Hospital of Capital Medical University, Beijing, PR China
| | - Ying Kan
- Department of Nuclear Medicine, 26455Beijing Friendship Hospital of Capital Medical University, Beijing, PR China
| | - Wei Wang
- Department of Nuclear Medicine, 26455Beijing Friendship Hospital of Capital Medical University, Beijing, PR China
| | - Jigang Yang
- Department of Nuclear Medicine, 26455Beijing Friendship Hospital of Capital Medical University, Beijing, PR China
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Söyler Y, Özmen Ö, Kabalak PA, Ertürk H, Uğurman F, Yılmaz Ü. The efficacy of 18F-FDG PET/CT in monitoring disease progression in malignant pleural mesothelioma. Rev Esp Med Nucl Imagen Mol 2023; 42:3-9. [PMID: 36152987 DOI: 10.1016/j.remnie.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE In the event of suspicion of malignant pleural mesothelioma (MPM) progression, imaging plays an important role. We aimed to evaluate the efficacy of 18F-FDG PET/CT in monitoring disease progression by comparing it with CT, and estimate median overall survival (OS) according to progression status with CT and 18F-FDG PET/CT. MATERIALS AND METHODS This was an observational, retrospective, single-institution study with MPM patients who had both 18F-FDG PET/CT and CT for monitoring disease progression from March 2009 to February 2020. Clinical features, radiological findings, and progression status according to CT [radiologic progression negative (RPN), radiologic progression positive (RPP)] and 18F-FDG PET/CT [metabolic progression negative (MPN), metabolic progression positive (MPP)] were recorded. The discrepancies and concordance between two methods were evaluated. The OS was estimated using the Kaplan-Meier method. RESULTS A total of 56 patients were included. There were thirty-one (55.3%) RPN and 25 (44.7%) RPP, while there were 26 (46.5%) MPN and 30 (53.5%) MPP. All RPP patients were also found to be MPP, however, among RPN, 5 patients (8.9% of all patients) were evaluated as MPP. The concordance between two methods in monitoring disease progression was very good (K = 0.423; p < 0.01). The OS was 26 ± 2.6 months in all patients. Kaplan-Meier curves between RPN and RPP, and between MPN and MPP did not show statistically significant differences (p = 0.56 and p = 0.25, respectively). CONCLUSIONS Both methods are equally acceptable in monitoring disease progression in MPM, even though 18F-FDG PET/CT detected more progression than CT did.
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Affiliation(s)
- Yasemin Söyler
- Department of Chest Diseases, Ankara Kecioren Sanatorium Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey.
| | - Özlem Özmen
- Department of Nuclear Medicine, Ankara Kecioren Sanatorium Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey.
| | - Pınar Akın Kabalak
- Department of Chest Diseases, Ankara Kecioren Sanatorium Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey.
| | - Hakan Ertürk
- Department of Radiology, Ankara Kecioren Sanatorium Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey.
| | - Feza Uğurman
- Department of Chest Diseases, Ankara Kecioren Sanatorium Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey.
| | - Ülkü Yılmaz
- Department of Chest Diseases, Ankara Kecioren Sanatorium Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey.
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Söyler Y, Özmen Ö, Kabalak P, Ertürk H, Uğurman F, Yılmaz Ü. La eficacia de [18F]FDG PET/TC en el seguimiento de la progresión de la enfermedad en el mesotelioma pleural maligno. Rev Esp Med Nucl Imagen Mol 2022. [DOI: 10.1016/j.remn.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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He J, Xu S, Pan H, Li S, He J. Does size matter? -a population-based analysis of malignant pleural mesothelioma. Transl Lung Cancer Res 2020; 9:1041-1052. [PMID: 32953483 PMCID: PMC7481612 DOI: 10.21037/tlcr-19-488] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background The 8th edition staging system for malignant pleural mesothelioma (MPM) has been proposed. The size of tumor is not taken into consideration. We intend to elucidate the prognostic value of the size of MPM and evaluate the current staging system via the data of SEER database. Methods All cases of primary MPM were identified and extracted from the SEER database during the period of 2004–2016. The endpoints were overall survival (OS) and cancer-specific survival (CSS) which were analyzed using Kaplan-Meier method. Log-rank test and Cox regression were utilized to identify the prognostic factors. Results A total of 2,138 patients were included in the primary cohort. The 1-, 3- and 5-year survival rates of MPM were 39.4%, 11.8% and 3.8%. Older, male and advanced stage patients accounted for larger proportion of the cohort. Besides tumor extension, lymph node involvement and metastatic status, tumor size, pathological type and differentiation grade were significant prognostic factors. In the stratified analysis of tumor extension, size is a significant prognostic factor in T2 patients and indicates inferior survival outcomes. Surgery, chemotherapy and radiation can increase both OS and CSS in MPM patients. Triple combination treatments showed a superiority to other treatments. Conclusions Tumor size matters in the prognosis of MPM especially in the early stage of MPM patients. The adjusted TNM staging system incorporating tumor size has better accuracy than the 8th edition IMIG system. However, some stages had not been fully identified. More cases of early stages are warranted for essential revision.
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Affiliation(s)
- Jiaxi He
- Department of Pathology, University of Maryland Baltimore, School of Medicine, Baltimore, MD, USA.,Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, Guangzhou, China.,National Clinical Research Center for Respiratory Disease, Guangzhou, China
| | - Songhui Xu
- Department of Pathology, University of Maryland Baltimore, School of Medicine, Baltimore, MD, USA
| | - Hui Pan
- Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, Guangzhou, China.,National Clinical Research Center for Respiratory Disease, Guangzhou, China
| | - Shuben Li
- Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, Guangzhou, China.,National Clinical Research Center for Respiratory Disease, Guangzhou, China
| | - Jianxing He
- Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease, Guangzhou, China.,National Clinical Research Center for Respiratory Disease, Guangzhou, China
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Nakajima Y, Kuribayashi K, Ishigaki H, Tada A, Negi Y, Minami T, Takahashi R, Doi H, Kitajima K, Yokoi T, Kijima T. Adenosine Deaminase in Pleural Effusion and Its Relationship with Clinical Parameters in Patients with Malignant Pleural Mesothelioma. Cancer Invest 2020; 38:356-364. [PMID: 32468861 DOI: 10.1080/07357907.2020.1776313] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Pleural effusion adenosine deaminase (ADA) levels are elevated in various diseases. We investigated whether pleural effusion ADA levels differ among patients with malignant pleural mesothelioma (MPM), lung cancer (LC), and benign diseases, including tuberculous pleurisy. We examined 329 patients from February 2002 to July 2013. There were 131 MPM cases with ADA levels of 32.29 IU/L; 117 LC cases with ADA levels of 21.12 IU/L; 54 benign disease cases with ADA levels of 20.98 IU/L. A significant difference existed in pleural effusion ADA levels between MPM and benign disease patients. Pleural effusion ADA levels were significantly higher in MPM patients.
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Affiliation(s)
- Yasuhiro Nakajima
- Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Kozo Kuribayashi
- Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.,Department of Thoracic Oncology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Hirotoshi Ishigaki
- Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Akio Tada
- Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Yoshiki Negi
- Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Toshiyuki Minami
- Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Ryo Takahashi
- Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Hiroshi Doi
- Department of Radiology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Kazuhiro Kitajima
- Department of Radiology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Takashi Yokoi
- Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.,Department of Thoracic Oncology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Takashi Kijima
- Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.,Department of Thoracic Oncology, Hyogo College of Medicine, Nishinomiya, Japan
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Kitajima K, Maruyama M, Minami T, Yokoi T, Kuribayashi K, Kijima T, Hashimoto M, Hasegawa S, Yamakado K. Comparison of modified Response Evaluation Criteria in Solid Tumors, European Organization for Research and Treatment of Cancer criteria, and PET Response Criteria in Solid Tumors for evaluation of tumor response to chemotherapy and prognosis prediction in patients with unresectable malignant pleural mesothelioma. Nucl Med Commun 2020; 41:790-799. [PMID: 32516245 DOI: 10.1097/mnm.0000000000001223] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To compare modified RECIST (mRECIST), EORTC criteria, and PERCIST for response evaluation and prognosis prediction in advanced malignant pleural mesothelioma (MPM) patients treated with chemotherapy. METHODS Patients with MPM and not curative surgery candidates (n = 75) underwent standard chemotherapy with cisplatin and pemetrexed. CT and [F]fluorodeoxyglucose PET/CT scans were performed at baseline and after three chemotherapy cycles. Chemotherapeutic response was evaluated according to mRECIST, EORTC, and PERCIST, then concordance among those was assessed using Cohen's κ coefficient. PFS and OS were examined using log-rank and Cox methods. RESULTS With EORTC, 27 patients had PMD, 23 SMD, 17 PMR, and eight CMR, while with PERCIST those were 28, 22, 11, and 14, respectively. Using mRECIST, 28 had PD, 29 SD, 18 PR, and 0 CR. Although there was high concordance between EORTC and PERCIST (82.7% of patients; κ = 0.83), that between mRECIST and EORTC (38.7%; κ = 0.27) and mRECIST and PERCIST (36.0%; κ = 0.26) was low. According to both EORTC and PERCIST, patients with no progression (CMR/PMR/SMD) showed significantly longer PFS and OS than PMD patients (EORTC: P = 0.0024 and P = 0.039, respectively, PERCIST: P = 0.0012 and P = 0.024, respectively), while according to mRECIST, those who achieved no progression (PR/SD) showed significantly longer PFS than PD patients (P = 0.011), but not significantly longer OS (P = 0.11). CONCLUSION EORTC and PERCIST are more accurate than mRECIST for evaluation of tumor response to chemotherapy and predicting prognosis in unresectable MPM patients.
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Affiliation(s)
| | | | - Toshiyuki Minami
- Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine
| | - Takashi Yokoi
- Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine
| | - Kozo Kuribayashi
- Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine
| | - Takashi Kijima
- Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine
| | - Masaki Hashimoto
- Department of Thoracic Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Seiki Hasegawa
- Department of Thoracic Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
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Mansfield AS, Peikert T, Vogelzang NJ, Symanowski JT. Effects of Reduction in Tumor Burden on Survival in Epithelioid Malignant Pleural Mesothelioma. Mayo Clin Proc 2018; 93:1026-1033. [PMID: 29804728 PMCID: PMC6077096 DOI: 10.1016/j.mayocp.2018.01.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 01/15/2018] [Accepted: 01/29/2018] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To understand the relationship between response and survival in malignant pleural mesothelioma (MPM). PATIENTS AND METHODS The original clinical trial was conducted from April 1999 through March 2001. Patients with epithelioid MPM (n=305) were categorized using modified pleural Response Evaluation Criteria in Solid Tumors by whether they responded to treatment. Median progression-free survival (PFS) and overall survival (OS) were estimated and hazard ratios for responders and nonresponders were estimated and compared using the log-rank test. Multivariable Cox proportional hazards models were used to adjust for baseline prognostic factors. RESULTS Patients who responded to frontline therapy had a significantly longer OS (hazard ratio, 0.34; 95% CI, 0.24-0.49; median, 20.6 months; 95% CI, 15.3 months to not reached) than did those who did not respond (median, 9.4 months; 95% CI, 8.1-11.0 months) (P<.001). Similarly, responders had a significantly longer PFS (hazard ratio, 0.50; 95% CI, 0.39-0.64; median, 7.8 months; 95% CI, 6.5-8.5 months) than did nonresponders (median, 3.7 months; 95% CI, 2.9-4.3 months) (P<.001). These results were confirmed when adjusting for baseline prognostic factors. We also observed a survival benefit associated with disease stabilization in MPM. CONCLUSION Our findings indicate that reduction in tumor burden or disease stabilization determined using modified pleural Response Evaluation Criteria in Solid Tumors is strongly associated with OS and PFS in epithelioid MPM.
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Affiliation(s)
| | - Tobias Peikert
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN
| | | | - James T Symanowski
- Department of Cancer Biostatistics, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC, and University of South Carolina Arnold School of Public Health, Columbia, SC
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FDG PET-derived parameters as prognostic tool in progressive malignant pleural mesothelioma treated patients. Eur J Nucl Med Mol Imaging 2018; 45:2071-2078. [DOI: 10.1007/s00259-018-4056-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 05/23/2018] [Indexed: 12/17/2022]
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Viteri S, Rosell R. An innovative mesothelioma treatment based on miR-16 mimic loaded EGFR targeted minicells (TargomiRs). Transl Lung Cancer Res 2018. [PMID: 29531894 DOI: 10.21037/tlcr.2017.12.01] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Santiago Viteri
- Dr Rosell Oncology Institute (IOR), Dexeus University Hospital, Barcelona, Spain
| | - Rafael Rosell
- Catalan Institute of Oncology, Germans Trias i Pujol Health Sciences Institute and Hospital, Badalona, Spain
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