Christopher Cao1, David H Tian2, Kristopher A Pataky2, Tristan D Yan3. 1. Collaborative Research (CORE) Group, Sydney, Australia; Department of Cardiothoracic Surgery, St George Hospital, Sydney, Australia; The Baird Institute for Applied Heart and Lung Surgical Research, Sydney, Australia. Electronic address: drchriscao@gmail.com. 2. Collaborative Research (CORE) Group, Sydney, Australia. 3. Collaborative Research (CORE) Group, Sydney, Australia; Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital, University of Sydney, Sydney, Australia.
Abstract
INTRODUCTION: Pleurectomy/decortication (P/D) in the treatment of malignant pleural mesothelioma includes a number of procedures with different clinical indications and therapeutic intents. To unify the nomenclature, IMIG and IASLC recently defined P/D-related procedures according to surgical technique, including 'extended P/D', 'P/D' and 'partial pleurectomy'. The present systematic review aimed to assess the safety and efficacy of these techniques. METHODS: A systematic review of relevant studies was performed by electronic search of five online databases from 1985 to 2012 by two independent reviewers according to predefined selection criteria. RESULTS: Thirty-four studies involving 1916 patients who underwent pleurectomy were included for quantitative analysis. These included 12 studies on 'extended P/D', 8 studies on 'P/D' and 14 studies on 'partial pleurectomy'. Perioperative mortality ranged from 0% to 11% and perioperative morbidity ranged from 13% to 43%. Median overall survival ranged from 7.1 to 31.7 months and disease-free survival ranged from 6 to 16 months. One study reported on quality-of-life outcomes using a standardized questionnaire suggesting superior outcomes for 'extended P/D' compared to extrapleural pneumonectomy. CONCLUSIONS: Results of the present systematic review suggested similar perioperative mortality outcomes between different P/D techniques but a trend towards higher morbidity and length of hospitalization for patients who underwent 'extended P/D'. However, overall and disease-free survival appeared to favour 'extended P/D' compared to less aggressive techniques. Future studies on P/D should adhere to recent definitions to enable accurate analysis of similar procedures. Direct comparisons of pleurectomy to extrapleural pneumonectomy remain challenging, and should be restricted to 'extended P/D' procedures only.
INTRODUCTION: Pleurectomy/decortication (P/D) in the treatment of malignant pleural mesothelioma includes a number of procedures with different clinical indications and therapeutic intents. To unify the nomenclature, IMIG and IASLC recently defined P/D-related procedures according to surgical technique, including 'extended P/D', 'P/D' and 'partial pleurectomy'. The present systematic review aimed to assess the safety and efficacy of these techniques. METHODS: A systematic review of relevant studies was performed by electronic search of five online databases from 1985 to 2012 by two independent reviewers according to predefined selection criteria. RESULTS: Thirty-four studies involving 1916 patients who underwent pleurectomy were included for quantitative analysis. These included 12 studies on 'extended P/D', 8 studies on 'P/D' and 14 studies on 'partial pleurectomy'. Perioperative mortality ranged from 0% to 11% and perioperative morbidity ranged from 13% to 43%. Median overall survival ranged from 7.1 to 31.7 months and disease-free survival ranged from 6 to 16 months. One study reported on quality-of-life outcomes using a standardized questionnaire suggesting superior outcomes for 'extended P/D' compared to extrapleural pneumonectomy. CONCLUSIONS: Results of the present systematic review suggested similar perioperative mortality outcomes between different P/D techniques but a trend towards higher morbidity and length of hospitalization for patients who underwent 'extended P/D'. However, overall and disease-free survival appeared to favour 'extended P/D' compared to less aggressive techniques. Future studies on P/D should adhere to recent definitions to enable accurate analysis of similar procedures. Direct comparisons of pleurectomy to extrapleural pneumonectomy remain challenging, and should be restricted to 'extended P/D' procedures only.
Authors: Egesta Lopci; Paolo Andrea Zucali; Giovanni Luca Ceresoli; Matteo Perrino; Laura Giordano; Letizia Gianoncelli; Elena Lorenzi; Maria Gemelli; Armando Santoro; Arturo Chiti Journal: Eur J Nucl Med Mol Imaging Date: 2014-11-18 Impact factor: 9.236
Authors: Mir Alireza Hoda; Thomas Klikovits; Madeleine Arns; Karin Dieckmann; Sabine Zöchbauer-Müller; Christian Geltner; Bernhard Baumgartner; Peter Errhalt; Barbara Machan; Wolfgang Pohl; Jörg Hutter; Josef Eckmayr; Michael Studnicka; Martin Flicker; Peter Cerkl; Walter Klepetko Journal: Wien Klin Wochenschr Date: 2016-07-25 Impact factor: 1.704
Authors: Thomas Klikovits; Mir Alireza Hoda; Yawen Dong; Madeleine Arns; Bernhard Baumgartner; Peter Errhalt; Christian Geltner; Barbara Machan; Wolfgang Pohl; Jörg Hutter; Josef Eckmayr; Michael Studnicka; Martin Flicker; Peter Cerkl; Klaus Kirchbacher; Walter Klepetko Journal: Wien Klin Wochenschr Date: 2016-07-25 Impact factor: 1.704
Authors: Eric Lim; Liz Darlison; John Edwards; Daisy Elliott; D A Fennell; Sanjay Popat; Robert C Rintoul; David Waller; Clinton Ali; Andrea Bille; Liz Fuller; Andreea Ionescu; Manjusha Keni; Alan Kirk; Pek Koh; Kelvin Lau; Talal Mansy; Nick A Maskell; Richard Milton; Dakshinamoorthy Muthukumar; Tony Pope; Amy Roy; Riyaz Shah; Jonathan Shamash; Zacharias Tasigiannopoulos; Paul Taylor; Sarah Treece; Kate Ashton; Rosie Harris; Katherine Joyce; Barbara Warnes; Nicola Mills; Elizabeth A Stokes; Chris Rogers Journal: BMJ Open Date: 2020-09-01 Impact factor: 2.692