Commentary: To scan or not to scan: No longer the question for mesothelioma patients after pleurectomy

Our plain-English summary of Commentary: To scan or not to scan: No longer the question for mesothelioma patients after pleurectomy, by E.A. David, S.M. Atay (The Journal of Thoracic and Cardiovascular Surgery, 2020).

The study

• Authors: E.A. David, S.M. Atay
• Journal: The Journal of Thoracic and Cardiovascular Surgery
• Published: 2020;160(4):1076-1077
• Type of article: Editorial, Comment
• Read it: PubMed · Publisher

In plain English

This is a commentary, not a new study. The authors, thoracic surgeons at the University of Southern California, discussed a study by De Leon and colleagues at Brigham and Women's Hospital on blood clots in the deep veins (deep venous thrombosis, or DVT) after pleurectomy/decortication, an operation for mesothelioma. As the commentators described it, that study included 93 patients in a surveillance program. Patients without symptoms had ultrasound scans of the arms and legs every 7 days. DVT was found in 27 (29%) patients, and 9 of those 27 (33%) had no symptoms. A standard risk score (the Caprini score) had estimated the risk at 10.7%. Median charges for the scans were estimated at $2103 per patient. All patients with clots in the arms had a central venous line in place. The commentators noted that the study did not address hospital labor and workflow, and that it was not powered to analyze the central-line group. The authors concluded that routine noninvasive DVT screening should be performed in these patients.

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: Commentary on another published study (De Leon and colleagues); it reports no new data of its own
• Who was studied: No population of its own. The commented study, as described here, was a series of 93 patients with mesothelioma treated with pleurectomy/decortication at Brigham and Women's Hospital who took part in a DVT surveillance program
• Exposure: No asbestos exposure is discussed. The subject is pleurectomy/decortication surgery for mesothelioma, followed by ultrasound (duplex) screening of the arms and legs for DVT every 7 days in patients without symptoms
• Main results:
  • As reported by the commentators for the De Leon study: DVT was found in 27 of 93 patients (29%), of whom 9 (33%) had no symptoms
  • For the same patients, the Caprini scoring system had estimated a postoperative DVT risk of 10.7%
  • The De Leon authors estimated median charges for upper- and lower-extremity ultrasound screening at $2103 per patient
  • In the Brigham series, all patients with upper-extremity DVT had a central venous line in place
• The authors' conclusion: The commentators concluded that routine noninvasive screening for DVT should be performed in patients undergoing pleurectomy/decortication for mesothelioma
• Limitations the authors state:
  • The commentators noted that the De Leon study did not address hospital labor and workflow
  • The commentators noted that the series was not powered for subset analysis of the patients with central lines

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

• Commentary: Focused attention on proactive identification of deep venous thrombosis after pleurectomy/decortication for malignant pleural mesothelioma — S.S. Groth, R.T. Ripley, et al. (2020)
• Commentary: Mesothelioma: The Guinness world record holder in thromboembolism — R.B. Cameron (2020)
• Routine surveillance for diagnosis of venous thromboembolism after pleurectomy for malignant pleural mesothelioma — L.E. De León, C.E. Bravo-Iñiguez, et al. (2020)
• Commentary to the article lung function not affected by asbestos exposure in workers with normal Computed Tomography scan, by Schikowsky, Felten, et al., 2017 — X. Baur, B. Terracini, et al. (2018)
• Loss of expression of BAP1 predicts longer survival in mesothelioma — M. Farzin, C.W. Toon, et al. (2015)
• Immune checkpoint inhibitors in non-small cell lung cancer (NSCLC): Approaches on special subgroups and unresolved burning questions — J. Remon, N. Vilariño, et al. (2018)

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