Three decades of experience in the surgical multi-modality management of pleural mesothelioma

Luckraz, Heyman; Rahman, Mesbah; Patel, Nishith; Szafranek, Adam; Gibbs, A R; Butchart, Eric G.

doi:10.1016/j.ejcts.2009.07.032

Cited by 53 publications

(53 citation statements)

References 15 publications

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“…In the context of multimodal therapy, Cao et al [24], on the basis of their meta-analysis, concluded that selected patients who underwent extended P/D had lower perioperative morbidity and mortality with similar, if not superior, long-term survival compared with those who underwent EPP. Furthermore, Lucklatz and others [22] reported that P/D combined with postoperative adjuvant therapy provided better survival compared with EPP, irrespective of factors such as advanced disease or surgically less fit patients.…”

Section: Why Is Survival After P/d Equal To or Even Better Than That mentioning

confidence: 99%

Extrapleural pneumonectomy or pleurectomy/decortication for malignant pleural mesothelioma

Hasegawa

2014

Gen Thorac Cardiovasc Surg

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Malignant pleural mesothelioma (MPM) is associated with a very poor prognosis. Unlike other solid tumors, any type of planned surgery for MPM would be cytoreductive rather than radical. There are two types of surgery for MPM. Extrapleural pneumonectomy (EPP) involves en bloc resection of the lung, pleura, pericardium, and diaphragm. Pleurectomy/decortication (P/D) is a lung-sparing surgery that removes only parietal/visceral pleura. In comparison with EPP, P/D is theoretically less radical but is associated with less perioperative mortality/morbidity and less postoperative deterioration of cardiopulmonary function. It still remains unclear which surgical technique is superior in terms of the risk/benefit ratio. In this context, selection between EPP and P/D has been a matter to debate.

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Section: Why Is Survival After P/d Equal To or Even Better Than That mentioning

confidence: 99%

Extrapleural pneumonectomy or pleurectomy/decortication for malignant pleural mesothelioma

Hasegawa

2014

Gen Thorac Cardiovasc Surg

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“…In the paper by Luckraz et al [21] the surgeon who first described surgical management of pleural mesothelioma in the 1970s (Butchart) is one of the authors. They describe their 30-year experience at their hospital.…”

Section: Resultsmentioning

confidence: 99%

Surgical Management of Malignant Pleural Mesothelioma: Impact of Surgery on Survival and Quality of Life—Relation to Chemotherapy, Radiotherapy, and Alternative Therapies

Papaspyros

2014

ISRN Surgery

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Introduction. Malignant pleural mesothelioma (MPM) is an aggressive cancer arising from pleural mesothelium. Surgery aims to either cure the disease or control the symptoms. Two surgical procedures exist: extrapleural pneumonectomy (EPP) and pleurectomy/decortication (P/D). In this systematic review we assess current evidence on safety and efficacy of surgery. Methods. Five electronic databases were reviewed from January 1990 to January 2013. Studies were selected according to a predefined protocol. Primary endpoint was overall survival. Secondary endpoints included quality of life, disease-free survival, disease recurrence, morbidity, and length of hospital stay. Results. Sixteen studies were included. Median survival ranged from 8.1 to 32 months for P/D and from 6.9 to 46.9 months for EPP. Perioperative mortality was 0%–9.8% and 3.2%–12.5%, respectively. Perioperative morbidity was 5.9%–55% for P/D and 10%–82.6% for EPP. Average length of stay was 7 days for P/D and 9 days for EPP. Conclusion. Current evidence cannot definitively answer which procedure (EPP or P/D) is more beneficial in terms of survival and operative risks. This systematic review suggests that surgery in the context of trimodality therapy offers acceptable perioperative outcomes and long-term survival. Centres specialising in MPM management have better results.

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“…A literature review evaluating reports in the last 10 years of outcomes after pleurectomy decortication demonstrates a median survival between 10 and 25 months (Table 1) (2,5,9,12,(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). Thirty-day mortality was between 0.0-6.8% across all studies.…”

Section: Discussionmentioning

confidence: 98%

Pleurectomy and decortication

Vlahu

Vigneswaran

2017

Ann. Transl. Med.

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Pleurectomy and decortication (P/D) improve survival and quality of life in selected patients with malignant pleural mesothelioma. The operative procedure was not standardized until recently. The goal of the operation is to perform a macroscopic complete resection of the tumor. This often involves resection of the parietal and visceral pleura and invariably a partial or complete resection and prosthetic reconstruction of ipsilateral hemidiaphragm. We describe our operative planning and technique as well as outcomes of P/D reported in current literature.

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Three decades of experience in the surgical multi-modality management of pleural mesothelioma

Cited by 53 publications

References 15 publications

Extrapleural pneumonectomy or pleurectomy/decortication for malignant pleural mesothelioma

Extrapleural pneumonectomy or pleurectomy/decortication for malignant pleural mesothelioma

Surgical Management of Malignant Pleural Mesothelioma: Impact of Surgery on Survival and Quality of Life—Relation to Chemotherapy, Radiotherapy, and Alternative Therapies

Pleurectomy and decortication

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