Propensity matched comparison of extrapleural pneumonectomy and pleurectomy/decortication for mesothelioma patients†

Kostron, Arthur; Friess, Martina; İnci, İlhan; Hillinger, Sven; Schneiter, Didier; Gelpke, Hans; Stahel, Rolf A.; Seifert, Burkhardt; Weder, Walter; Opitz, Isabelle

doi:10.1093/icvts/ivw422

Cited by 40 publications

(44 citation statements)

References 23 publications

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“…After title and abstract screening, 401 (30‐day mortality) and 343 (postoperative complications) papers were excluded because the articles were irrelevant to the research question. Full‐text analysis yielded 20 distinct datasets covering 30‐day mortality and 19 distinct datasets covering postoperative complications in EPP and P/D (Table ) …”

Section: Resultsmentioning

confidence: 99%

Short‐term outcomes of pleurectomy decortication and extrapleural pneumonectomy in mesothelioma

Gerwen

Wolf

Liu

et al. 2018

Journal of Surgical Oncology

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Background/Objectives We evaluated postoperative mortality and complications after extrapleural pneumonectomy (EPP) and pleurectomy decortication (P/D) to better understand their effectiveness in malignant pleural mesothelioma (MPM). Methods A meta‐analysis was done to evaluate 30‐day mortality and postoperative complications. In addition, in‐patients data of 500 eligible patients with MPM who underwent EPP or P/D was extracted from the New York Statewide Planning and Research Cooperative System (SPARCS). Multivariate analyses and propensity matching were used to compare in‐hospital mortality and postoperative complications in EPP vs P/D. Results The meta‐analysis showed a statistically significant difference in 30‐day mortality (5% [95% CI: 4‐6] vs P/D 2% [95% CI: 1‐3]), proportion of complications (46% [95% CI: 36‐56] vs 24% [95% CI: 15‐34]) and postoperative arrhythmias (20% [95% CI: 12‐31] vs 5% [95% CI: 2‐8]) for EPP vs P/D. In‐hospital mortality (OR adj: 2.6; 95% CI: 0.86‐7.75) and postoperative complications (OR adj: 1.1; 95% CI: 0.68‐1.86) were not different in EPP compared with P/D while supraventricular arrhythmia was significantly more frequent after EPP vs P/D (OR adj: 5.2; 95% CI: 2.34‐11.33). Conclusions Postoperative mortality, postoperative complications, and particularly supraventricular arrhythmia are less frequent after P/D vs EPP. P/D, a less invasive surgery, may provide a better option when technically feasible for patients with MPM.

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Section: Resultsmentioning

confidence: 99%

Short‐term outcomes of pleurectomy decortication and extrapleural pneumonectomy in mesothelioma

Gerwen

Wolf

Liu

et al. 2018

Journal of Surgical Oncology

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“…In one meta-analysis, the short-term mortality rate (perioperatively and within 30 days) was 4.5% in EPP and 1.7% in P/D. 9) In other studies, the median survival durations of patients who [6][7][8]11) which are not satisfactory results in large-scale studies. Additionally, no consensus regarding which procedure is superior to the other has yet been reached.…”

Section: Discussionmentioning

confidence: 96%

“…Many reports [6][7][8] have compared the outcomes of P/D and EPP in terms of morbidity, mortality, and survival, suggesting that P/D is comparable with EPP in terms of various surgical outcomes. Taioli et al 9) recommend P/D because of its 2.5-fold lower short-term mortality.…”

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confidence: 99%

Is Pleurectomy/Decortication Superior to Extrapleural Pneumonectomy for Patients with Malignant Pleural Mesothelioma? A Single-Institutional Experience

Miyazaki

Yamasaki

Tsuchiya

et al. 2018

ATCS

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“…After many years of tradition in performing EPP for MPM patients, our institution shifted towards EPD in more than 90% of the cases with similar survival outcomes (Figures 4,5) [ (89) and updated unpublished data] and very low mortality rates after EPD (0%). Generally, mortality rates are certainly lower after EPD as described in a systematic review by Cao et al of 2.9% compared to 6.8% after EPP.…”

Section: Allocation To P/d Epd or Eppmentioning

confidence: 99%

Patient selection for radical surgery for mesothelioma—prognostic factors in a multimodality approach

Lauk¹,

Opitz²

2018

Shanghai Chest

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In the absence of standardized treatment algorithms for malignant pleural mesothelioma patients, one of the main difficulties remains patient allocation to therapies with potential benefit. In the following article, we discuss clinical, pathological and molecular prognostic factors, which have been investigated over the past years to simplify and at the same time specify patient selection for multimodality treatment.

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Propensity matched comparison of extrapleural pneumonectomy and pleurectomy/decortication for mesothelioma patients†

Cited by 40 publications

References 23 publications

Short‐term outcomes of pleurectomy decortication and extrapleural pneumonectomy in mesothelioma

Short‐term outcomes of pleurectomy decortication and extrapleural pneumonectomy in mesothelioma

Is Pleurectomy/Decortication Superior to Extrapleural Pneumonectomy for Patients with Malignant Pleural Mesothelioma? A Single-Institutional Experience

Patient selection for radical surgery for mesothelioma—prognostic factors in a multimodality approach

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