Should Lung-Sparing Surgery Be the Standard Procedure for Malignant Pleural Mesothelioma?

Abstract

<jats:p>Background: Surgical procedures for malignant pleural mesothelioma (MPM) include extrapleural pneumonectomy (EPP), extended pleurectomy/decortication (P/D) and P/D. EPP has been applied to MPM for a long time, but the postoperative status is extremely poor due to the loss of one whole lung. We compared the mortality, morbidity and median survival time (MST) of lung-sparing surgery (extended P/D or P/D) and lung-sacrificing surgery (EPP) for MPM by performing a systematic review. Methods: We extracted the number of events and patients from the literature identified in electronic databases. Ultimately, 15 reports were selected, and 2674 MPM patients, including 1434 patients undergoing EPP and 1240 patients undergoing extended P/D or P/D, were analyzed. Results: Our systematic review showed that lung-sparing surgery was significantly superior to lung-sacrificing surgery in both the surgical-related mortality (extended P/D vs. EPP: 3.19% vs. 7.65%, p &lt; 0.01; P/D vs. EPP: 1.85% vs. 7.34%, p &lt; 0.01) and morbidity (extended P/D vs. EPP: 35.7% vs. 60.0%, p &lt; 0.01; P/D vs. EPP: 9.52% vs. 20.89%, p &lt; 0.01). Lung-sparing surgery was not inferior to EPP in terms of MST. Conclusion: Although no prospective randomized controlled trial has been conducted, it may be time to change the standard surgical method for MPM from lung-sacrificing surgery to lung-sparing surgery.</jats:p>

[Retracted] Study on the Predictive Value of P53 Protein Expression in Brain Metastasis in NSCLC and the Mechanism of miR‐424 Reversing Platinum Resistance in NSCLC

“…Lung cancer is a common malignant tumor that occurs in the lungs of patients in clinical practice. Relevant clinical research data show that the number of lung cancer patients in China is increasing year by year, and the five-year survival rate of patients is less than 20% [ 1 ]. At present, non-small-cell lung cancer (NSCLC) still lacks sensitive and effective diagnostic markers.…”

Biomarkers for Malignant Pleural Mesothelioma—A Novel View on Inflammation

“…Patients face a devastating prognosis of 12 months median survival only after diagnosis [1]. Despite recent-and, in part, promising-developments regarding both systemic therapy and cytoreductive surgery, MPM remains a clinical challenge, especially when it comes to treatment allocation [2,3]. Furthermore, the optimal (multimodal) treatment regimens still remain to be defined from the available arsenal of immune therapy, surgery, radiation and systemic treatment [4].…”

Second Surgery for Recurrent Malignant Pleural Mesothelioma after Multimodality Treatment: A Systematic Review

“…No correlation with the type of first surgery is individuate [ 10 ]. The predominance of the EPP as first surgery is reported; in fact, only in recent years [ 17 , 18 ], P/D has become the method of choice worldwide.…”