Improving Survival Results after Surgical Management of Malignant Pleural Mesothelioma: An Australian Institution Experience

• Yan Tristan D.

  Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital, Sydney, Australia The Baird Institute for Applied Heart and Lung Surgical Research, Sydney, Australia

• Cao Christopher Q.

  Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital, Sydney, Australia The Baird Institute for Applied Heart and Lung Surgical Research, Sydney, Australia

• Boyer Michael

  Department of Medical Oncology, Royal Prince Alfred Hospital, Sydney, Australia Sydney Cancer Center, Sydney, Australia

• Tin Mo Mo

  Sydney Cancer Center, Sydney, Australia Department of Radiation Oncology, Royal Prince Alfred Hospital, Sydney, Australia

• Kennedy Catherine

  Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital, Sydney, Australia The Baird Institute for Applied Heart and Lung Surgical Research, Sydney, Australia

• McLean Jocelyn

  Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital, Sydney, Australia The Baird Institute for Applied Heart and Lung Surgical Research, Sydney, Australia

• Bannon Paul G.

  Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital, Sydney, Australia The Baird Institute for Applied Heart and Lung Surgical Research, Sydney, Australia

• McCaughan Brian C.

  Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital, Sydney, Australia The Baird Institute for Applied Heart and Lung Surgical Research, Sydney, Australia

抄録

Background: There has been an evolving role of surgery for malignant pleural mesothelioma (MPM) over the past 25 years. The objective of this study was to investigate whether the survival results for MPM patients after surgery have improved within this time period by an analysis of a prospective cohort of 540 patients.<br>Methods: Five hundred and forty consecutive patients with MPM were treated by a thoracic surgical team. These patients were categorized into two groups: Group I (before September 1999, n = 270) and Group II (after September 1999, n = 270). The two groups were compared for clinicopathologic data and survival results. The statistical analyses of all prognostic parameters used overall survival as the endpoint.<br>Results: Group II had higher proportions of epithelial tumors and patients who had preoperative PET scan, extrapleural pneumonectomy (EPP), postoperative radiotherapy and pemetrexed chemotherapy. The overall survival results were significantly better in Group II compared with Group I (p = 0.004). Four factors were found to be independently associated with an improved survival in multivariate analysis: epithelial subtype (p <0.001); surgeon’s experience with >100 cases (p = 0.006), patients who underwent EPP (p = 0.001) and those who received pemetrexed chemotherapy (p = 0.016). The median survival for patients selected for EPP was 20 months, as compared to 9 months for pleurodesis/decortication and pleurodesis.<br>Conclusions: Significant improvement of overall survival results has been achieved in the more recent 270 MPM patients through accumulated experience in a specialist treatment center.

収録刊行物

• Annals of Thoracic and Cardiovascular Surgery

  Annals of Thoracic and Cardiovascular Surgery 17 (3), 243-249, 2011

  Annals of Thoracic and Cardiovascular Surgery 編集委員会

キーワード

• pleural mesothelioma
• pleurectomy
• decortication
• pleurodesis and extrapleural pneumonectomy

詳細情報

• CRID: 1390001204729951104
• NII論文ID: 10029686999
• NII書誌ID: AA11035352
• DOI: 10.5761/atcs.oa.10.01572
• ISSN: 21861005
• ISSN: 13411098
• Web Site: https://search.jamas.or.jp/link/ui/2012046904
• 本文言語コード: en
• データソース種別:
  • JaLC
  • Crossref
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可