Objectives: Mesothelioma is a nearly uniformly fatal tumor. Multimodality therapy including cytoreductive surgery and chemotherapy is associated with long-term survival in some patients. Cytoreductive surgery for thoracic disease includes a lung-sparing operation called an "extended pleurectomy/decortication" or a lung-sacrificing surgery called an "extrapleural pneumonectomy." The benefit of cytoreductive surgery for bicavitary disease (chest and abdomen) is poorly understood. Our objective was to evaluate the long-term survivals for patients undergoing cytoreductive surgery for bicavitary disease and to determine whether any prognostic factors were associated with outcome.
Methods: We reviewed our Institutional Review Board-approved, institutional, International Association for the Study of Lung Cancer Mesothelioma Staging Project database. Inclusion criteria were all patients who underwent cytoreductive surgery for bicavitary disease. Overall survival was calculated by Kaplan-Meier methodology. All International Association for the Study of Lung Cancer database elements were evaluated by univariable analysis.
Results: From February 2014 to August 2021, 440 patients with mesothelioma were evaluated. Fourteen patients (3%) underwent cytoreductive surgery of both chest and abdomen as a planned 2-stage operation. Most patients (13/14; 93%) underwent chest surgery before abdomen surgery. For the entire cohort, the median overall survival was 33.6 months with a 5-year survival of 20%. Extended pleurectomy/decortication was associated with a better outcome compared with extrapleural pneumonectomy, with median overall survivals of 58.2 versus 13.5 months, respectively.
Conclusions: For a highly selected group of patients with bicavitary mesothelioma, long-term survival can be achieved with an aggressive, staged surgical approach. The patients who undergo extended pleurectomy/decortication with preservation of the lung appear to have more favorable outcomes compared with patients undergoing extrapleural pneumonectomy.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jtcvs.2022.11.035 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Severe postoperative pancreatitis following treatment of peritoneal metastases.
Eur J Surg Oncol
January 2025
Program in Peritoneal Surface Malignancy, Washington Cancer Institute, Washington, DC, USA. Electronic address:
Postoperative pancreatitis is an unusual complication of upper abdominal surgery that can result in severe morbidity and has been associated with postoperative death. It can be caused by trauma to the surface of the gland, injury to pancreatic ducts, vascular compromise, ductal obstruction within the pancreas parenchyma or because of duodenal stagnation. Our database of peritoneal surface malignancy patients was surveyed in a search for patients who manifested signs and symptoms of severe postoperative pancreatitis.
View Article and Find Full Text PDFEnhancing multidisciplinary collaboration in ovarian cancer surgery.
Int J Gynecol Cancer
January 2025
Gynecologic Oncologic Centre South, Department of Obstetrics and Gynecology, Catharina Hospital Eindhoven, the Netherlands.
Computed tomography-based prediction of interval cytoreduction in advanced ovarian cancer.
Int J Gynecol Cancer
January 2025
Subdirección de Investigación Básica, Instituto Nacional de Cancerología, Tlalpan, Mexico City, Mexico. Electronic address:
Objective: Our retrospective study aimed to investigate the role of computed tomography (CT) using both the tomographic Fagotti index and the Sugarbaker peritoneal cancer index (PCI) in predicting the feasibility of optimal interval debulking surgery in epithelial ovarian cancer.
Methods: Patients with advanced ovarian cancer treated in our institution who were eligible for interval debulking surgery were identified and included in the study. A retrospective image collection was operated, and CT scan evaluations were conducted by 2 independent radiologists to establish both scores (Fagotti index and Sugarbaker PCI).
Successful laparoscopic cytoreductive surgery for multiple (three) advanced recurrences of AGCT in a young woman. A case report.
Int J Surg Case Rep
January 2025
Department of Medical Sciences and Public Health, University of Cagliari, SS 554, km 4,500, 09042 Monserrato, Italy.
Introduction And Importance: Debulking surgery is the main approach for recurrent adult granulosa cell tumors (AGCTs), but the effectiveness of laparoscopic extensive cytoreduction in advanced cases and its impact on quality of life (QoL) remains unclear.
Case Presentation: A 34-year-old woman, who had a right adnexectomy for AGCT in 2020, was referred with an 8-month history of a large left ovarian cyst and amenorrhea. Preoperative evaluations indicated a recurrence 18 months post-diagnosis.
Gingival Debulking Surgery for a Child With Severe Aplastic Anemia: A Case Report.
Spec Care Dentist
January 2025
Paediatric Dentistry, The University of Western Australia, Dental School, Perth, Australia.
Introduction: Aplastic anemia (AA) is a rare condition that frequently manifests with pancytopenia. Management of severe disease is through either allogenic stem cell transplantation or immunosuppressive therapy with supportive care. Drug-induced gingival overgrowth (DIGO) is a potential complication of a number of medications, including cyclosporine and amlodipine.
View Article and Find Full Text PDFWant 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!