The pattern of lymph node involvement influences outcome after extrapleural pneumonectomy for malignant mesothelioma

Abstract

The classical anatomic location is not as important as the scatter of nodal involvement. Every effort should be made to obtain biopsy specimens from as many stations as possible before undertaking extrapleural pneumonectomy for malignant mesothelioma.

Malignant pleural mesothelioma: clinicopathologic and survival characteristics in a consecutive series of 394 patients☆

“…In an effort to control symptoms and prolong survival of MPM patients, several multimodality treatment regimens, combining the so called maximal cytoreductive surgery, chemotherapy, and/or radiation therapy, have been implemented, either in an adjuvant [4][5][6] or neoadjuvant setting [8,9]. From these studies, it appears that multimodality therapies may provide a survival improvement in selected patients.…”

Differential Expression of Ki-67 and Sex Steroid Hormone Receptors Between Genders in Peritoneal Mesothelioma

“…Non-epithelial tumors such as biphasic and sarcomatoid tumors are associated with a poorer prognosis compared to the epithelioid tumors [9]. Lymphatic invasion indicate a poorer prognosis [10][11][12]. Patient factors such as poor performance status and male gender have also been shown to result in a poorer prognosis [13].…”

The Value of Occult Disease in Resection Margin and Lymph Node After Extrapleural Pneumonectomy for Malignant Mesothelioma

“…Functional assessment (ie, complete and differential blood cell counts, urea nitrogen, creatinine clearance, bilirubin, and liver enzymes) was repeated before each cycle. Dose reduction and delay in therapy were established according to hematologic and nonhematologic toxicity, scored according to the common toxicity criteria (from 0 ϭ no toxicity to 4 ϭ maximal toxicity) [11]. Chemotherapy was started between 4 and 10 weeks after extrapleural pneu-monectomy depending on the postoperative recovery.…”

“…These tumoral nests are likely located in proximity of resection margins or in mediastinal nodes not adequately assessed at the time of thoracotomy. Indeed, positive resection margins and mediastinal lymph node metastases have been identified as poor prognostic factors in many published series [3][4][5][6][7][8][9][10][11][12]. However, some patients experience a poor outcome despite a histologically proven complete surgical resection.…”