Extrapleural Pneumonectomy and Pleurectomy Decortication: Can We Really Compare Their Survival?

Our plain-English summary of Extrapleural Pneumonectomy and Pleurectomy Decortication: Can We Really Compare Their Survival?, by P. Bertoglio, S. Korasidis (The Annals of Thoracic Surgery, 2015).

The study

• Authors: P. Bertoglio, S. Korasidis
• Journal: The Annals of Thoracic Surgery
• Published: 2015;100(4):1508-9
• Type of article: Letter, Comment
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This item is a short letter to the editor, not a research study, and it reports no new data. The authors responded to a meta-analysis by Taioli and coworkers that compared survival after two operations for malignant pleural mesothelioma: extrapleural pneumonectomy and pleurectomy decortication. The authors wrote that the best treatment for this cancer has not yet been found. They said surgery cannot be used alone, even in early-stage disease, and must be combined with other therapies before and after the operation. They argued that surgeons choose the operation case by case according to tumor stage and histology, so patient groups differ greatly and survival can hardly be compared. Citing other authors, they said the two operations have different indications and should not be considered alternatives. They also called pleurectomy decortication a 'Pandora's box' covering many lung-sparing techniques that vary by surgeon. The authors ended by asking whether comparing long-term survival in such a varied population treated with multimodal therapies is really possible and meaningful. The letter 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: Letter to the editor commenting on a published meta-analysis; no original data
• Who was studied: No patients were studied. The letter discusses the meta-analysis by Taioli and coworkers of surgery for malignant pleural mesothelioma.
• Exposure: Not applicable. The letter does not discuss asbestos or any other exposure. Its subject is two operations for malignant pleural mesothelioma: extrapleural pneumonectomy and pleurectomy decortication.
• Main results:
  • The authors' view (no data given): the best treatment for malignant pleural mesothelioma leading to satisfactory long-term results has not been found.
  • The authors' view: surgery cannot be considered alone, even in early-stage disease, and must be combined with other therapies before (neoadjuvant) and after (adjuvant) surgery.
  • The authors' argument: because the operation is chosen according to tumor stage and histology, patient groups differ greatly and survival and postoperative courses can hardly be compared.
  • Citing Wolf and colleagues, the authors stated that the two operations have different indications and should not be considered alternative treatments.
  • The authors' argument: the definition of pleurectomy decortication covers a wide range of lung-sparing approaches that vary with the surgeon's technique.
• The authors' conclusion: The authors questioned whether comparing long-term survival in such a varied population of patients treated with multimodal therapies is really possible and meaningful.

Topics

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

Medical terms in this study, explained in our Lexicon: Extrapleural Pneumonectomy (EPP).

Related studies

• Meta-analysis of survival after pleurectomy decortication versus extrapleural pneumonectomy in mesothelioma — E. Taioli, A.S. Wolf, et al. (2015)
• Extrapleural pneumonectomy or pleurectomy/decortication for malignant pleural mesothelioma — S. Hasegawa (2014)
• Extrapleural Pneumonectomy Versus Pleurectomy/Decortication for Malignant Pleural Mesothelioma — N. Zhou, D.C. Rice, et al. (2022)
• Current Treatment of Mesothelioma: Extrapleural Pneumonectomy Versus Pleurectomy/Decortication — A.S. Wolf, R.M. Flores (2016)
• Short-term outcomes of pleurectomy decortication and extrapleural pneumonectomy in mesothelioma — M. van Gerwen, A. Wolf, et al. (2018)
• Pleurectomy/decortication is superior to extrapleural pneumonectomy in the multimodality management of patients with malignant pleural mesothelioma — L. Lang-Lazdunski, A. Bille, et al. (2012)

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