Meta-Analysis of Survival After Pleurectomy Decortication Versus Extrapleural Pneumonectomy in Mesothelioma

Pleurectomy/decortication versus extrapleural pneumonectomy: a critical choice

“…The median survival is better in P/D group (16 months P/D vs. 12 months EPP), as reported by Flores and colleagues in a retrospective review of 633 patients from three Institutions (25). A recent meta-analysis of outcome after P/D and EPP has confirmed that EPP patients have a significantly higher proportion of short-term mortality (4.5% EPP vs. 1.7% P/D, P<0.005) and complications, compared to P/D, while there has no statistical difference in 2-year mortality between the two groups (23.8% EPP vs. 25% P/D, P=0.8) (32). Furthermore, patients receiving P/D are able to better tolerate adjuvant CT by the simple fact of having two lungs.…”

Novel systemic therapy against malignant pleural mesothelioma

“…The median age of diagnosis in the United States is 72 years. Asbestos exposure was first identified as a cause of MPM in the 1960's, and it is estimated that up to 80% of cases of MPM are related to asbestos exposure with the onset of disease generally occurring 20-70 years after exposure through mechanisms of chronic inflammation (3)(4)(5). The incidence of MPM in the United States has stabilized over the past few years likely due to decreased asbestos use since the 1970's (1); however, the incidence of MPM in developing countries is expected to increase and represents a substantial health and economic burden (6,7).…”

Validation of EORTC and CALGB prognostic models in surgical patients submitted to diagnostic, palliative or curative surgery for malignant pleural mesothelioma

“…In fact, patients of our cohort submitted to EPP and P/D, showed a better survival than those submitted to a diagnostic or palliative procedure (P=0.013; Figure 3) probably referable to patient selection (fit and young, with a good PS) and disease stage (favourable histology, surgically approachable). This has been evidenced by a meta-analysis with a consistent number of patients treated with P/D and EPP, concluding that P/D should be preferred to EPP whenever feasible (11). The debate on whether P/D is superior to EPP or vice-versa is still on going but with a growing recognition that P/D offers a good compromise between long-term survival and postoperative quality of life if compared to EPP (11)(12)(13)(14)(15)(16)(17)(18).…”