Surgically debulked malignant pleural mesothelioma: Results and prognostic factors View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

1997-04

AUTHORS

Harvey I. Pass, Karen Kranda, Barbara K. Temeck, Irwin Feuerstein, Seth M. Steinberg

ABSTRACT

Background: We analyzed morbidity and mortality, sites of recurrence, and possible prognostic factors in 95 (78 male, 17 female) patients with MPM on phase I–III trials since 1990. A debulking resection to a requisite, residual tumor thickness of ≤ 5 mm was required for inclusion.Methods: Preoperative tumor volumes were determined by three-dimensional reconstruction of chest computerized tomograms. Pleurectomy (n=39) or extrapleural pneumonectomy (EPP; n=39) was performed. Seventeen patients could not be debulked. Preoperative EPP platelet counts (404,000) and mean tumor volume (491 cm3) were greater than that seen for pleurectomy (344,000, 114 cm3).Results: Median survival for all patients was 11.2 months, with that for pleurectomy 14.5 months, that for EPP 9.4 months, and that for unresectable patients 5.0 months. Arrhythmia (n=14; 15%) was the most common complication, and there were two deaths related to surgery (2.0%). Tumor volume of >100 ml, biphasic histology, male sex, and elevated platelet count were associated with decreased survival (p<0.05). Both EPP and pleurectomy had equivalent recurrence rates (27 of 39 [69%] and 31 of 39 [79%], respectively); however, 17 of 27 EPP recurrences as opposed to 28 of 31 pleurectomy recurrences were locoregional (p2=0.013).Conclusions: Debulking resections for MPM can be performed with low operative mortality. Size and platelet count are important preoperative prognostic parameters for MPM. Patients with poor prognostic indicators should probably enter nonsurgical, innovative trials where toxicity or response to therapy can be evaluated. More... »

PAGES

215-222

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/bf02306613

DOI

http://dx.doi.org/10.1007/bf02306613

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1007693079

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/9142382


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