Case-control study between extrapleural pneumonectomy and radical pleurectomy/decortication for pathological N2 malignant pleural mesothelioma☆

Autor: John G. Edwards, Antonio E. Martin-Ucar, Apostolos Nakas, David A. Waller
Rok vydání: 2007
Předmět:
Zdroj: European Journal of Cardio-Thoracic Surgery. 31:765-770
ISSN: 1010-7940
Popis: Objective: To compare the outcomes of extrapleural pneumonectomy (EPP) and radical pleurectomy/decortication (P/D) for N2 malignant pleuralmesothelioma(MM).Patientsandmethods:Inaretrospective case-controlstudyweanalysedtheresultsofthe57 patients[49maleand8 female, median age 59 (range 14—70) years] who underwent radical surgery for MM found to have pathological N2 disease over a 7-year-period. EPP was performed on 45 and P/D on 12 patients. Prognostic factors, postoperative course, pathological data and postoperative survival were analysed. Results: Those in the P/D group were significantly older (median age 62 vs 58 years, p = 0.03) than in the EPP group. There was no difference in postoperative hospital stay (p = 0.1) nor T stage (p = 0.7) between the groups. There were no significant differences in the proportion of patients undergoing some adjuvant therapy in each group (p = 0.2). Mean survival from diagnosis was 15 months in the EPP group and 16 months for those who underwent P/D (p = 0.4). Conclusions: Preservation of the lung during radical surgery for N2 MM does not compromise survival even in an older group population. We therefore now have ceased to perform EPP in cases of N2 disease and we make every effort to accurately stage patients with mediastinoscopy to identify them. # 2007 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.
Databáze: OpenAIRE