Commentary: Know your enemy-Understanding futility in the battle against malignant pleural mesothelioma

Our plain-English summary of Commentary: Know your enemy-Understanding futility in the battle against malignant pleural mesothelioma, by A.E. Giles, B. Kidane (The Journal of Thoracic and Cardiovascular Surgery, 2020).

The study

• Authors: A.E. Giles, B. Kidane
• Journal: The Journal of Thoracic and Cardiovascular Surgery
• Published: 2020;159(6):2523-2524
• Type of article: Editorial, Comment
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This was a short commentary by two authors from Winnipeg, Canada, not an original study. It discussed a separate article by Burt and colleagues on predicting before surgery whether malignant pleural mesothelioma can be removed. As the commentary described it, Burt and colleagues looked back at 170 patients who had surgery and measured chest cavity volume on CT scans. Fourteen percent had disease that could not be removed because of diffuse chest wall invasion. Comparing the affected side of the chest with the unaffected side, a 5% decrease in cavity volume had a sensitivity of 75%, specificity of 57% and accuracy of 60% for predicting this invasion, and did better than MRI. The commentators noted that the method was not validated, agreement between radiologists was not assessed, and the small sample meant confounding could not be controlled. The authors concluded that chest volume analysis may improve prediction of unresectability but is not ready for immediate use, and needs further development and validation. The commentary does not discuss asbestos.

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: Invited commentary (editorial) on another study published in the same journal; no original data
• Who was studied: No patients were studied by these authors. The commentary describes a retrospective study by Burt and colleagues of 170 patients undergoing surgery for malignant pleural mesothelioma.
• Main results:
  • As reported by the commentary, in Burt and colleagues' series of 170 surgical patients, 14% had unresectable disease because of diffuse chest wall invasion.
  • As reported by the commentary, Burt and colleagues compared the affected with the unaffected hemithorax and found that a 5% decrease in thoracic cavity volume had a sensitivity of 75%, specificity of 57% and accuracy of 60% for predicting diffuse chest wall invasion.
  • As reported by the commentary, Burt and colleagues' CT volume method outperformed magnetic resonance imaging assessment.
• The authors' conclusion: The authors concluded that new uses of chest volume analysis may improve prediction of unresectability in malignant pleural mesothelioma, and that developing and validating such tools is a promising area. They also said the study's limitations preclude immediate use of thoracic cavity volume to decide resectability before surgery.
• Limitations the authors state:
  • The commentators said Burt and colleagues' method was not validated, in either technique or outcomes.
  • The commentators said agreement between radiologists was not assessed in Burt and colleagues' study.
  • The commentators said that, because of the small sample size and number of events, Burt and colleagues could not control for confounding.

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: Pleural Mesothelioma.

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