BTS guideline for the investigation and management of malignant pleural mesothelioma

Woolhouse, Ian; Bishop, Lesley; Darlison, Liz; Fonseka, Duneesha de; Edey, Anthony; Edwards, John; Faivre-Finn, Corinne; Fennell, Dean A.; Holmes, Steve; Kerr, Keith M.; Nakas, Apostolos; Peel, Tim; Rahman, Najib M.; Slade, Mark; Steele, Jeremy; Tsim, Selina; Maskell, Nick A

doi:10.1136/bmjresp-2017-000266

Cited by 37 publications

(27 citation statements)

References 2 publications

(1 reference statement)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There was no difference in quality of life, chest pain, analgesia requirement, or overall development of procedure tract metastasis between groups. Major international guidelines now recommend against the routine use of prophylactic irradiation [29, 43, 44]. …”

Section: Discussionmentioning

confidence: 99%

“…Although this was a single-centered study, we feel that our results are generalizable to that of other tertiary-care centers managing MPM. Patients at our institution are treated according to internationally recognized standards and guidelines for the management of MPM [29, 43]. Our results, however, cannot be applied to non-MPM patients as the incidence of CTM is known to be higher in patients with MPM compared to other malignancies [21].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Catheter Tract Metastasis in Mesothelioma Patients with Indwelling Pleural Catheters: A Retrospective Cohort Study

et al. 2018

View full text Add to dashboard Cite

Background: Use of indwelling pleural catheters (IPCs) for the management of symptomatic pleural effusions in patients with mesothelioma has increased in popularity. An important concern with this approach is the potential for the development of catheter tract metastasis (CTM). Objectives: To determine the incidence of IPC-related CTM in patients with malignant pleural mesothelioma (MPM). Methods: In this single-center retrospective cohort study, patients with biopsy-confirmed MPM who had an IPC inserted between May 2006 and July 2017 were identified from a prospectively collected database. Thoracic CT scans following IPC insertion were reviewed to assess for evidence of CTM. Patients were followed until death or last documented patient encounter with a minimum of 6-month follow-up. Results: A total of 90 patients were included in the cohort. CTM was identified in 23 of 90 patients (26%). Median time from IPC insertion to CTM was 408 days (interquartile range 196–721 days). Medical thoracoscopy at the time of IPC insertion did not lead to a significantly increased odds of CTM (OR 2.30; 95% CI 0.66–7.94; p = 0.19). Incidence of CTM was not different between mesothelioma subtypes (p = 0.09). Patient-reported dyspnea scores were improved following IPC insertion in 80% of patients. Conclusions: CTM was identified in over a quarter of MPM patients when follow-up imaging was reviewed. Treating physicians should be cognizant of the possibility of CTM at the site of prior IPC.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Catheter Tract Metastasis in Mesothelioma Patients with Indwelling Pleural Catheters: A Retrospective Cohort Study

et al. 2018

View full text Add to dashboard Cite

show abstract

“…The British Thoracic Society guidelines recommend patients should be offered 3 to 4 monthly follow-up appointments with an oncologist, respiratory physician, or specialist nurse according to their current treatment plan. 75 Progression-free survival, if reported, is usually longer after EPP in comparison to P/D, and especially the local recurrence rates are higher in P/D groups. 38 The most recent comprehensive meta-analysis was conducted to compare if P/D or EPP is more beneficial to MPM patients.…”

Section: Epp and P/d -Comparisonmentioning

confidence: 92%

Surgery in Malignant Pleural Mesothelioma

Bueno

Opitz

2018

Journal of Thoracic Oncology

View full text Add to dashboard Cite

Surgical intervention plays an important role in the diagnosis, staging, and treatment of malignant pleural mesothelioma (MPM) and can be applied with curative or palliative intent. The overall aim of surgery should be, as in any oncologic surgery, the macroscopic complete resection (MCR) of the tumor. Most importantly, the majority of patients with the diagnosis of MPM should be appropriately staged and initially evaluated in a multidisciplinary setting, including medical oncology, radiation oncology, and surgery after histologic diagnosis. Surgical staging, including determination of the histologic subtype and lymph node status, as well as clinical staging with positron-emission tomography-computer tomography scan and determination of cardiopulmonary reserve are crucial. Herein, we summarize the role of surgical resection, specifically macroscopic complete resection, performed as extrapleural pneumonectomy or extended pleurectomy/decortication in multimodality treatment settings and advocate for optimal patient selection for one or the other procedure. In addition, the roles of surgery in diagnosis of MPM and in palliative care are discussed.

show abstract

“…Depending on the PET endpoint used some studies have shown a role in baseline prognostication but no ability to monitor disease (6). The recent BTS guidelines on mesothelioma do not recommend the routine use of PET-CT except in patients "where excluding distant metastases will change management" (12). A potential future direction of study is the assessment of PET as a prognostic marker for lung cancer in patients with pleural effusions who might otherwise have been amenable for surgical resection.…”

Section: Editorialmentioning

confidence: 99%

Imaging for malignant pleural effusions—still no routine role of positron emission tomography

Arnold¹,

Maskell²

2019

J. Thorac. Dis

View full text Add to dashboard Cite

BTS guideline for the investigation and management of malignant pleural mesothelioma

Abstract: The full guideline for the investigation and management of malignant pleural mesothelioma is published in Thorax. The following is a summary of the recommendations and good practice points. The sections referred to in the summary refer to the full guideline.

Cited by 37 publications

References 2 publications

Catheter Tract Metastasis in Mesothelioma Patients with Indwelling Pleural Catheters: A Retrospective Cohort Study

Catheter Tract Metastasis in Mesothelioma Patients with Indwelling Pleural Catheters: A Retrospective Cohort Study

Surgery in Malignant Pleural Mesothelioma

Imaging for malignant pleural effusions—still no routine role of positron emission tomography

Contact Info

Product

Resources

About