Objectives: Medical management based on palliative chemotherapy is currently the standard of care in malignant pleural mesothelioma (MPM). Median survival of 12-16 months has been reported with modern chemotherapy regimens with or without anti-angiogenic agents. Multimodality therapy incorporating cytoreductive surgery, systemic chemotherapy and radiotherapy has been offered for years to fit patients with early-stage disease, but its role remains debated. Our objective was to compare overall survival in patients offered multimodality therapy in a specialized clinic setting in London, UK to that of patients offered exclusively medical treatment at another academic institution in Quebec, Canada.
Materials And Methods: We retrospectively compared the survival rates of 2 separate cohorts of patients treated consecutively: Cohort 1 (n = 106) received multimodality therapy including systemic chemotherapy, extended pleurectomy/decortication (P/D) and prophylactic radiotherapy in London (United Kingdom) between 2009 and 2016, while Cohort 2 (n = 98) received medical treatment at the Quebec Heart and Lung Institute (Canada) during the same period.
Results: In Cohort 1, all patients but two completed trimodality therapy. In cohort 2, 51 % received palliative care only and 40 % received systemic chemotherapy. Median survival was 32 months vs 10 months in Cohort 1 and Cohort 2, respectively (hazard ratio with age, gender, pathology and TNM staging as covariates: 3.81; 95 % CI: 2.67-5.45; p < 0.0001). Similar results were obtained in sensitivity analyses, after excluding those who received best supportive care only and in a propensity score-matched analysis.
Conclusion: Aggressive therapy of MPM using cancer-directed surgery, systemic chemotherapy and prophylactic radiotherapy may provide a significant survival benefit in selected patients.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.lungcan.2021.04.025 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Timing of Surgery and Postoperative Outcomes in Esophagectomy for Squamous Cell Carcinoma: A Prospective Study in North India.
J Gastrointest Cancer
January 2025
MM Medical College Sadopur, Haryana, India.
Purpose: Neoadjuvant chemotherapy followed by esophagectomy is the usual approach to manage esophageal squamous cell carcinoma (ESCC). The optimal interval to operate after completion of neoadjuvant chemoradiotherapy (NACRT) still remains controversial.
Methods: A prospective study was conducted to observe and compare postoperative complications and pathological outcomes in patients with squamous cell carcinoma of the esophagus who underwent NACRT followed by surgery within 8 weeks or after 8 weeks of NACRT completion.
Postoperative concurrent chemoradiotherapy plus apatinib for patients with high-grade glioma: a retrospective cohort study.
Chin Clin Oncol
December 2024
Department of Radiotherapy, The 900th Hospital of the Joint Logistics Team (Dongfang Hospital), Xiamen University, Fuzhou, China.
Background: Radiotherapy plus temozolomide followed by adjuvant temozolomide was the standard treatment for high-grade gliomas. This study aimed to explore the effectiveness and safety of the addition of apatinib in patients with high-grade gliomas after surgery.
Methods: In this retrospective cohort study, patients with high-grade glioma [World Health Organization (WHO) grade III or IV] treated with apatinib and concurrent chemoradiotherapy (cCRT) after surgery from October 2017 to February 2021 were reviewed.
Pretreatment plasma vitamin D and response to neoadjuvant chemotherapy in breast cancer: evidence from pooled analysis of cohort studies.
Int J Surg
December 2024
Department of Oncology and Cancer Institute, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
Background: Biological evidence has revealed antitumor effect of vitamin D, but whether it could predict the response to neoadjuvant chemotherapy (NAC) in breast cancer (BC) patients remains inconclusive. The aim was to investigate the association between pretreatment vitamin D level and response to NAC and subsequent survival outcomes in BC patients.
Materials And Methods: The authors systematically searched the Medline, Embase, Cochrane Library, and Web of Science databases and clinical trial registries to identify relevant articles from inception to 8 October 2024.
Effect of electroacupuncture on discomfort in patients undergoing colonoscopy: protocol for a multicentre, randomised, controlled clinical trial.
BMJ Open
December 2024
Department of Anesthesiology, Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
Introduction: Colonoscopy is currently the most commonly used and effective method for early detection, diagnosis and treatment of tumours of the colon and rectum. However, similar to other invasive procedures, it is associated with adverse reactions such as pain and abdominal distension. Electroacupuncture (EA) has been proposed as a potential treatment for relieving this discomfort; however, there is limited evidence supporting its efficacy.
View Article and Find Full Text PDFObjective: This study aims to investigate the effects of video scenario-based breathing training on interleukin-4 (IL-4), interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α), and interferon-γ (IFN-γ) in children with Mycoplasma pneumonia.
Methods: A total of 106 children with Mycoplasma pneumonia treated in our hospital from February 2022 to April 2024 were selected. According to different nursing methods, children receiving routine intervention were assigned to the control group, while those undergoing video scenario-based breathing training were assigned to the training group.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!