Does mediastinal lymph node involvement influence the surgical outcome in malign pleural mesothelioma?
| Autor: | Bedirhan MA; Depatment of Thoracic Surgery, Yedikule Chest Disease and Thoracic Surgery Hospital, İstanbul, Turkey., Seyrek Y; Department of Thoracic Surgery, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Hospital, Istanbul, Turkey., Yaran V; Depatment of Thoracic Surgery, Yedikule Chest Disease and Thoracic Surgery Hospital, İstanbul, Turkey., Sezen CB; Depatment of Thoracic Surgery, Yedikule Chest Disease and Thoracic Surgery Hospital, İstanbul, Turkey., Cansever L; Depatment of Thoracic Surgery, Yedikule Chest Disease and Thoracic Surgery Hospital, İstanbul, Turkey., Metin M; Depatment of Thoracic Surgery, Yedikule Chest Disease and Thoracic Surgery Hospital, İstanbul, Turkey. |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | Acta chirurgica Belgica [Acta Chir Belg] 2023 Oct; Vol. 123 (5), pp. 517-524. Date of Electronic Publication: 2022 Jul 15. |
| DOI: | 10.1080/00015458.2022.2099558 |
| Abstrakt: | Background: This study examined the effect of metastatic mediastinal lymph node involvement on the prognosis of patients with malignant pleural mesothelioma (MPM) who underwent extrapleural pneumonectomy (EPP) or extended pleurectomy (E/P) and also to assess the effect of metastatic mediastinal lymph node involvement on the prognosis of patients with MPM in these group of patients. Methods: This retrospective study included 84 patients with MPM (66 men [78.6%] and 18 women [21.4%]) who underwent EPP ( n = 44) or E/P ( n = 40) at our institution between January 2001 and July 2019. Survival analyses were performed according to histopathology, nodal status, and surgical approach. Results: In the EPP group, patients with T2-N2 status had a significantly better mean survival (17 ± 2.1 months) than patients with T3-N2 (7.3 ± 1.6 months) or T4-N2 (3.2 ± 1.1 months) status ( p = .001). In the E/P group, patients with T2-N2 status had a mean survival of 18 ± 1.1 months, while patients with T3-N2 and T4-N2 status had mean survival durations of 6.6 ± 1.6 and 4.8 ± 1.2 months, respectively ( p = .159). In both treatment groups, the survival rates of patients with epithelial tumors were better than those of patients with non-epithelial tumors, independent of N status. None of the patients with N2 disease survived until 5 years postoperatively. Conclusion: In summary, our results suggested that mediastinal lymph node metastasis negatively influenced the prognosis of patients with T3 MPM, regardless of treatment by EPP or E/P. Under these circumstances, preoperative cervical mediastinoscopy or endobronchial ultrasound-guided transbronchial needle aspiration may be considered for patients with high-stage MPM who are scheduled for surgery with curative intent. In our study, N2 status was spotted as a significant factor affecting survival, nevertheless its significance in survival of pleural mesothelioma patients should be analyzed in multi-centered studies. |
| Databáze: | MEDLINE |
| Externí odkaz: |
|