Malignant pleural mesothelioma: A survival study

Harvey, James C.; Fleischman, E H; Kagan, A. Robert; Streeter, Oscar

doi:10.1002/jso.2930450109

Cited by 32 publications

(15 citation statements)

References 5 publications

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“…In seven reports 8,20,21,24,25,31,32 there is a breakdown by stage of operated patients ( Table 1). The staging systems have varied over time and are more comprehensively reported in some recent papers, for example in 2008 by Nakas.…”

Section: Resultsmentioning

confidence: 99%

“…21 In some, particularly more recent series, PD is performed with radical intent. 8 We judge that resection of the diaphragm or pericardium was infrequently performed in early series because it is specifically mentioned if done 16,31,32 whereas it is included in the general operative description in more recent reports. 5,8,11,13 It appears that it was optional with a degree of selection for appropriateness but it is often unclear in how many patients these steps were taken ( Table 2).…”

Section: Resultsmentioning

confidence: 99%

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A systematic review of lung-sparing extirpative surgery for pleural mesothelioma

et al. 2011

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SummaryObjectives There is a resurgence of interest in lung-sparing extirpative surgery for malignant pleural mesothelioma with recent reports of better survival and fewer adverse consequences than with extrapleural pneumonectomy. However, these operations are not well-characterized and to offer evidence-based clinical recommendations and to plan future trials a summary of what is already known is required.Design A formal literature search was performed and all recovered titles were sequentially sifted by title, abstract and full-text reading according to prespecified criteria. Papers were selected if they contained data relevant to the area of enquiry. Quantitative synthesis and textual analysis, appropriate to the material, were performed.Setting Follow-up studies of patients undergoing surgery for malignant pleural mesothelioma in specialist thoracic or cardiothoracic units.Participants Among the operated patients described in these papers, a total of 1270 patients had undergone lung-sparing surgery for mesothelioma.Results There were no randomized trials or other forms of controlled studies. From 464 titles, 26 papers contained sufficient data on 1270 patients to be included in the systematic review. Operative descriptions for all series were extracted and tabulated and variation was found in the nature of surgery within and between series, and the degree of detail with which it was described. There was more operative detail in recent papers. All available numerical data were extracted, tabulated and summarized using quantitative methods. The average survival at 1, 2, 3, 4 and 5 years was 51%, 26%, 16%, 11% and 9%, respectively. There were no data on patients' performance status, symptomatic change, or other patient reported outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

A systematic review of lung-sparing extirpative surgery for pleural mesothelioma

et al. 2011

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“…Most reports of survival of patients with MM describe the experience of people referred to secondary or tertiary referral centres for consideration of treatment or for entry into treatment trials [7][8][9][10][11][12][13]. As a result, selection of younger patients with higher performance status who have a better prognosis occurs.…”

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confidence: 99%

Predicting survival in malignant mesothelioma

Musk¹,

Olsen²,

Alfonso³

et al. 2011

Eur Respir J

103

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Malignant mesothelioma (MM) of the pleura or peritoneum is a universally fatal disease attracting an increasing range of medical interventions and escalating healthcare costs.Changes in survival and the factors affecting survival of all patients ever diagnosed with MM in Western Australia over the past five decades and confirmed by the Western Australian Mesothelioma Registry to December 2005 were examined. Sex, age, date and method of diagnosis, site of disease and histological type were recorded. Date of onset of symptoms and performance status were obtained from clinical notes for a sample of cases. Cox regression was used to examine the association of the clinical variables and the 10-yr periods of disease onset with survival after diagnosis.Survival was inversely related to age, being worse for males (hazard ratio (HR) 1.4, 95% CI 1.2-1.6), and those with peritoneal mesothelioma (HR 1.4, 95% CI 1.1-1.7). Patients with sarcomatoid histology had worse prognosis than patients with epithelioid and biphasic histological subtypes. Survival improved after the 1970s and has made incremental improvements since then. Median (interquartile range) survival by decade, from 1960 until 2005, was 64 (0-198), 177 (48-350), 221 (97-504), 238 (108-502) and 301 (134-611) days; ,4 weeks of this apparent improvement can be attributed to earlier diagnosis.With increasing resources and treatment costs for MM over the past 40 yrs, there have been modest improvements in survival but no complete remissions.

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“…Prognosis could only be improved by an aggressive approach with multimodality treatment including extrapleural pneumonectomy, followed by combination chemoradiotherapy, in a selected subgroup of patients [3]. However, long survivors of MPM have been reported by various authors [4, 5, 6]. The present report describes a case of MPM with unexpectedly long survival, without active treatment.…”

Section: Introductionmentioning

confidence: 86%