| Title: |
Pleurectomy-decortication in malignant pleural mesothelioma: are different surgical techniques associated with different outcomes? Results from a multicentre study |
| Authors: |
Marulli G; Breda C; Fontana P; Ratto GB; Leoncini G; Alloisio M; Infante M; Luzzi L; Paladini P; Oliaro A; Ruffini E; Benvenuti MR; Pariscenti G; Spaggiari L; Casiraghi M; Rusca M; Carbognani P; Ampollini L; Facciolo F; Leuzzi G; Mucilli F; Camplese P; Romanello P; Perissinotto E; Rea F. |
| Contributors: |
G. Marulli; C. Breda; P. Fontana; G. Ratto; G. Leoncini; M. Alloisio; M. Infante; L. Luzzi; P. Paladini; A. Oliaro; E. Ruffini; M. Benvenuti; G. Pariscenti; L. Spaggiari; M. Casiraghi; M. Rusca; P. Carbognani; L. Ampollini; F. Facciolo; G. Leuzzi; F. Mucilli; P. Camplese; P. Romanello; E. Perissinotto; F. Rea |
| Publication Year: |
2017 |
| Collection: |
The University of Milan: Archivio Istituzionale della Ricerca (AIR) |
| Subject Terms: |
Malignant pleural mesothelioma; Pleurectomy-decortication; Prognostic factor; Settore MED/21 - Chirurgia Toracica |
| Description: |
OBJECTIVES: The potential benefit of surgery for malignant pleural mesothelioma (MPM), especially concerning pleurectomy/decortication (P/D), is unclear from the literature. The aim of this study was to evaluate the outcome after multimodality treatment of MPM involving different types of P/D and to analyse the prognostic factors. METHODS: We reviewed 314 patients affected by MPM who were operated on in 11 Italian centres from 1 January 2007 to 11 October 2014. RESULTS: The characteristics of the population were male/female ratio: 3.7/1, and median age at operation was 67.8 years. The epithelioid histotype was observed in 79.9% of patients; neoadjuvant chemotherapy was given to 57% of patients and Stage III disease was found following a pathological analysis in 62.3% of cases. A total of 162 (51.6%) patients underwent extended P/D (EP/D); 115 (36.6%) patients had P/D and 37 (11.8%) received only a partial pleurectomy. Adjuvant radiotherapy was delivered in 39.2% of patients. Median overall survival time after surgery was 23.0 [95% confidence interval (CI): 19.6-29.1] months. On multivariable (Cox) analysis, pathological Stage III-IV [P = 0.004, hazard ratio (HR):1.34; 95% CI: 1.09-1.64], EP/D and P/D (P = 0.006, HR for EP/D: 0.46; 95% CI: 0.29-0.74; HR for P/D: 0.52; 95% CI: 0.31-0.87), left-sided disease (P = 0.01, HR: 1.52; 95% CI: 1.09-2.12) and pathological status T4 (P = 0.0003, HR: 1.38; 95% CI: 1.14-1.66) were found to be independent significant predictors of overall survival. CONCLUSIONS: Whether the P/D is extended or not, it shows similarly good outcomes in terms of early results and survival rate. In contrast, a partial pleurectomy, which leaves gross tumour behind, has no impact on survival. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/28419212; info:eu-repo/semantics/altIdentifier/wos/WOS:000404869200008; Annual Meeting of the European Association for Cardio-Thoracic Surgery : October, 1st – 5th; volume:52; issue:1; firstpage:63; lastpage:69; numberofpages:7; journal:EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY; https://hdl.handle.net/2434/868704 |
| DOI: |
10.1093/ejcts/ezx079 |
| Availability: |
https://hdl.handle.net/2434/868704; https://doi.org/10.1093/ejcts/ezx079 |
| Rights: |
info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.B13728C2 |
| Database: |
BASE |