Discussion

Our plain-English summary of Discussion (The Journal of Thoracic and Cardiovascular Surgery, 2018).

The study

• Journal: The Journal of Thoracic and Cardiovascular Surgery
• Published: 2018;155(6):2732-2733
• Type of article: Comment
• Read it: PubMed · Publisher

In plain English

This item is not a research article. It is the published transcript of the discussion that followed a conference presentation by Batirel and colleagues (Istanbul, Turkey). Their study looked at macroscopic complete resection (MCR), meaning surgery that removes all visible tumor, in patients with malignant pleural mesothelioma. The study itself is not included here, and asbestos exposure is not discussed. A discussant noted that MCR was achieved in 49% of patients, and the presenting author described the cohort as 150 patients. The MCR group survived 6 to 8 months longer than the non-MCR group and did better in years 2 and 3, but the difference was not statistically significant. Five-year survival rates were the same in both groups. The non-MCR group included patients who had only a biopsy-type procedure, and it had more sarcomatoid and biphasic tumors. The presenting author said a power analysis showed at least 355 patients were needed to demonstrate a 10% survival difference, so the data lacked enough power. The presenting author suggested that 5-year survival depends more on the biology of the disease.

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: Published transcript of the discussion following a conference presentation of a surgical study; not the study itself
• Who was studied: Patients with malignant pleural mesothelioma treated by the presenting author's group in Istanbul, Turkey; described in the discussion as 150 patients; dates not given
• Exposure: No asbestos exposure is discussed. The subject is surgery: macroscopic complete resection (MCR) versus non-MCR, including extrapleural pneumonectomy and pleurectomy and decortication
• Main results:
  • MCR was achieved in 49% of patients (figure stated by the discussant Dr Opitz)
  • The MCR group had 6 to 8 months better survival than the non-MCR group, including better survival in years 2 and 3, but this was not statistically significant
  • Five-year survival rates were the same in the MCR and non-MCR groups
  • The non-MCR group included patients who had no surgical resection, only a biopsy procedure (small thoracotomy, video-assisted thoracoscopy, or talc)
  • Sarcomatoid and biphasic tumors were more frequent in the non-MCR group
  • The diaphragm was removed in about 20% of patients (the presenting author was unsure of the exact figure) and in all extrapleural pneumonectomy patients
• The authors' conclusion: The presenting author suggested that 5-year survival is more related to the biology of the disease, while survival at 2 to 3 years may be influenced by the type of surgery or by macroscopic complete resection
• Limitations the authors state:
  • The study was underpowered: a power analysis showed at least 355 patients were needed to demonstrate a 10% survival difference
  • More patients are needed to see whether there is a difference
  • Frozen sections were not done to confirm that a diaphragm that looked normal was free of tumor

Topics

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

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