Single-Center 20-Year Experience in Surgical Treatment of Malignant Pleural Mesothelioma

Mangiameli, Giuseppe; Bottoni, Edoardo; Cariboni, Umberto; Ferraroli, Giorgio Maria; Morenghi, Emanuela; Giudici, Veronica Maria; Voulaz, Emanuele; Alloisio, Marco; Testori, Alberto

doi:10.3390/jcm11154537

Cited by 3 publications

(1 citation statement)

References 42 publications

(64 reference statements)

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“…Since the surgical approach is traditionally recommended for non-sarcomatoid MPM, the most common histopathological subtypes in surgical series are epithelioid and biphasic MPM [ 15 , 16 ]. Bovolato et al [ 13 ] reported that the most common histopathological subtype was epithelioid MPM, and the survival of sarcomatoid MPM was significantly worse.…”

Section: Discussionmentioning

confidence: 99%

Survival Effect of Complete Multimodal Therapy in Malignant Pleural Mesothelioma

et al. 2022

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Background: Malignant pleural mesothelioma (MPM) is an aggressive pleural malignancy, and despite all multimodal treatment modalities, the 5-year overall survival rate of patients with MPM is less than 20%. In the present study, we aimed to analyze the surgical and prognostic outcomes of patients with MPM who received multimodal treatment. Methods: In this retrospective, single-center study, the records of patients who underwent surgery for MPM between January 2010 and December 2020 at our department were reviewed retrospectively. Results: Sixty-four patients were included in the study, of whom 23 (35.9%) were women and 41 (64.1%) were men. Extrapleural pneumonectomy, pleurectomy/decortication, and extended pleurectomy/decortication procedures were performed in 34.4%, 45.3%, and 20.3% of patients, respectively. The median survival of patients was 21 months, and the 5-year survival rate was 20.2%. Advanced tumor stage (hazard ratio [HR], 1.8; p=0.04), right-sided extrapleural pneumonectomy (HR, 3.1; p=0.02), lymph node metastasis (HR, 1.8; p=0.04), and incomplete multimodal therapy (HR, 1.9; p=0.03) were poor prognostic factors. There was no significant survival difference according to surgical type or histopathological subtype. Conclusion: Multimodal therapy can offer an acceptable survival rate in patients with MPM. Despite its poor reputation in the literature, the survival rate after extrapleural pneumonectomy, especially left-sided, was not as poor as might be expected.

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Section: Discussionmentioning

confidence: 99%

Survival Effect of Complete Multimodal Therapy in Malignant Pleural Mesothelioma

et al. 2022

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Optimal surgery for resectable malignant pleural mesothelioma in the setting of multimodality treatment

Kondo

Hasegawa

2023

Surg Today

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The surgical treatment of malignant pleural mesothelioma (MPM) involves procedures to achieve macroscopic complete resection, depending on the patient’s condition. We reviewed the evolution of surgical approaches for resectable MPM. Since surgery is no more than a single step in the set of processes in multimodality treatment (MMT), we concluded that these procedures should give precedence to lung preservation and minimize resection whenever possible. Postoperative quality of life must be prioritized when the patient can receive appropriate adjuvant therapy.

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Anaesthetic and perioperative considerations for extrapleural pneumonectomy and extended pleurectomy/decortication: a scoping review protocol

Yip,

Weinberg,

Gooi

et al. 2024

BMJ Open

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IntroductionExtrapleural pneumonectomy (EPP) and extended pleurectomy/decortication (ePD) are surgical cytoreductive techniques aimed at achieving macroscopic resection in malignant pleural tumours such as pleural mesothelioma, non-mesothelioma pleural malignancies such as thymoma and sarcoma, and rarely for pleural tuberculosis, in a more limited fashion. Despite extensive studies on both surgical techniques and consequences, a significant knowledge gap remains regarding how best to approach the perioperative anaesthesia challenges for EPP and ePD.It is unknown if the risk stratification processes for such surgeries are standardised or what types of functional and dynamic cardiac and pulmonary tests are employed preoperatively to assist in the perioperative risk stratification. Further, it is unknown whether the types of anaesthesia and analgesia techniques employed, and the types of haemodynamic monitoring tools used, impact on outcomes. It is also unknown whether individualised haemodynamic protocols are used to guide the rational use of fluids, vasoactive drugs and inotropes.Finally, there is a dearth of evidence regarding how best to monitor these patients postoperatively or what the most effective enhanced recovery protocols are to best mitigate postoperative complications and accelerate hospital discharge. To increase our knowledge of the perioperative and anaesthetic treatment for patients undergoing EPP/ePD, this scoping review attempts to synthesise the literature and identify these knowledge gaps.Methods and analysisThis scoping review will be conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Review Protocols methodology. Electronic databases, OVID Medline, EMBASE and the Cochrane Library, will be systematically searched for relevant literature corresponding to EPP or ePD and perioperative or anaesthetic management. Data will be analysed and summarised descriptively and organised according to the three perioperative stages: preoperative, intraoperative and postoperative factors in clinical care.Ethics and disseminationEthics approval was not required. The findings will be disseminated through professional networks, conference presentations and publications in scientific journals.

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Single-Center 20-Year Experience in Surgical Treatment of Malignant Pleural Mesothelioma

Cited by 3 publications

References 42 publications

Survival Effect of Complete Multimodal Therapy in Malignant Pleural Mesothelioma

Survival Effect of Complete Multimodal Therapy in Malignant Pleural Mesothelioma

Optimal surgery for resectable malignant pleural mesothelioma in the setting of multimodality treatment

Anaesthetic and perioperative considerations for extrapleural pneumonectomy and extended pleurectomy/decortication: a scoping review protocol

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