ASO Author Reflections: Postoperative Radiotherapy for Patients with Mesothelioma-Past, Present, and Future

Our plain-English summary of ASO Author Reflections: Postoperative Radiotherapy for Patients with Mesothelioma-Past, Present, and Future, by G.D. Lewis, B.S. Teh (Annals of Surgical Oncology, 2019).

The study

• Authors: G.D. Lewis, B.S. Teh
• Journal: Annals of Surgical Oncology
• Published: 2019;26(Suppl 3):635-636
• Type of article: Comment
• Read it: PubMed · Publisher

In plain English

This is a brief invited commentary, not a new study. In it, the authors reflected on their own separate article, "The Role of Adjuvant Radiotherapy in the Treatment of Pleural Mesothelioma," published in the same journal in 2019. That study used the National Cancer Data Base to look at patients with malignant mesothelioma from 2004 to 2013. It asked what role radiation given after surgery plays. As described here, patients who had surgery plus radiotherapy had a median survival of 21.4 months, compared with 16.59 months for surgery alone (P less than 0.001). Radiotherapy was more often given after a surgery called extrapleural pneumonectomy than after lung-sparing surgery. In a multivariable analysis, surgery plus radiotherapy, chemotherapy and higher socioeconomic status were associated with improved overall survival. After propensity matching, surgery plus radiotherapy and chemotherapy were still associated with improved overall survival. The authors noted that because the study was retrospective, selection bias was possible. They said ongoing prospective clinical trials must continue to enrol patients to answer the question more definitively. The commentary does not give patient numbers and does not discuss asbestos exposure.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Brief invited commentary (ASO Author Reflections) by the authors on their own retrospective study of a national cancer database, which was published as a separate article
• Who was studied: Patients with malignant mesothelioma in the National Cancer Data Base (NCDB), 2004–2013. The commentary does not give the number of patients.
• Exposure: Not asbestos. The treatment studied was radiotherapy given after surgical resection (adjuvant radiotherapy), compared with surgery alone. Chemotherapy and type of surgery (extrapleural pneumonectomy versus lung-sparing approaches) were also considered.
• Main results:
  • In the companion study, the surgery plus radiotherapy group had a median survival of 21.4 months, compared with 16.59 months in the surgery-alone group (P less than 0.001).
  • Radiotherapy was more likely to be given after extrapleural pneumonectomy (EPP) than after lung-sparing surgical approaches.
  • On multivariable analysis, surgery plus radiotherapy, chemotherapy and higher socioeconomic status were associated with improved overall survival (P less than 0.0001).
  • After propensity matching, surgery plus radiotherapy and chemotherapy were still associated with improved overall survival (P less than 0.05).
• The authors' conclusion: The authors concluded that, given the lack of clear evidence to guide adjuvant management of malignant pleural mesothelioma, their study gives information on the usefulness of adjuvant radiotherapy. They said ongoing prospective clinical trials must continue to enrol patients to answer the question more definitively.
• Limitations the authors state:
  • The study was retrospective, so selection bias is possible.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Mesothelioma.

Related studies

• Asbestos use and asbestos-related diseases in Asia: past, present and future — G.V. le, K. Takahashi, et al. (2011)
• Exposure to asbestos: past, present and future — E. Pira, F. Donato, et al. (2018)
• Manipulating microRNAs for the Treatment of Malignant Pleural Mesothelioma: Past, Present and Future — G. Reid, T.G. Johnson, et al. (2020)
• Surgical treatment of malignant peritoneal mesothelioma: past, present, and future — H.R. Alexander (2010)
• The ghost of public health journalism: past, present, and future — G.S. Cooper, R.C. Brown (2010)
• An association between postoperative radiotherapy for primary breast cancer in 11 National Surgical Adjuvant Breast and Bowel Project (NSABP) studies and the subsequent appearance of pleural mesothelioma — M. Deutsch, S.R. Land, et al. (2007)

Browse more research in Annals of Surgical Oncology, or return to medical research.