Extrapleural pneumonectomy for sarcomas report of two cases

Our plain-English summary of Extrapleural pneumonectomy for sarcomas report of two cases, by A.V. Bedini, L. Tavecchio, V. Delledonne (Tumori, 2000).

The study

• Authors: A.V. Bedini, L. Tavecchio, V. Delledonne
• Journal: Tumori
• Published: 2000;86(5):422-3
• Type of article: Case report
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Aims And Background: Extrapleural pneumonectomy (EPP), which is a very uncommon surgical procedure, is electively indicated only in patients with early stages of malignant pleural mesothelioma, a rare condition. Two adults suffering from sarcomas and treated with EPP are described here.

Methods: A 29-year-old male with four left-sided lung metastases and ipsilateral pleural effusion from a chondrosarcoma of the mandibula and a 64-year old woman with a megamass in the left chest due to a local recurrence of a hemangiopericytoma underwent EPP.

Results: Extra-EPP-field multiorgan progression was diagnosed 14 months following surgery in the first patient who died at the 24th postoperative month but remained free of disease at the site of surgery. The second patient had a chest wall relapse at the forty-third month following EPP, which was treated by partial resection of the second and third ribs. She is alive and disease-free at the twelfth postoperative month.

Discussion: EPP may be considered for salvage treatment in selected patients with intrathoracic sarcomas not amenable to other effective therapies to achieve mid- to long-term disease control, even in the case of advanced spread.

In plain English

This was a two-case report from the National Cancer Institute in Milan, Italy; it did not study asbestos exposure. The authors described two adults with sarcomas treated by extrapleural pneumonectomy (EPP), an operation they noted is usually reserved for early-stage malignant pleural mesothelioma. The first patient, a 29-year-old man, had lung metastases and fluid around the left lung from a chondrosarcoma of the jaw (mandibula). Disease spread outside the operated area 14 months after surgery. He died at the 24th postoperative month (twenty-second, per the discussion) but stayed disease-free in the left chest. The second patient was a woman aged 64 in the case description but 54 in the article's own abstract. She had a very large left-chest mass from a recurrent hemangiopericytoma unresponsive to chemotherapy. A chest wall relapse found in the forty-third month after EPP was removed by partial resection of two ribs. She was alive and disease-free at the twelfth month of her third surgical follow-up. The authors concluded that EPP could be considered as salvage treatment in selected patients with intrathoracic sarcomas not amenable to other therapies.

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: Case report of two patients
• Who was studied: Two adults with sarcomas treated at the National Cancer Institute of Milan, Italy. The first was a 29-year-old man with lung metastases from a chondrosarcoma of the mandibula. The second was a woman with a local recurrence of a hemangiopericytoma in the left chest. Her age is 64 in the case description but 54 in the article's abstract.
• Exposure: No asbestos or fiber exposure was studied. The article concerns a surgical treatment, extrapleural pneumonectomy, for sarcomas.
• Main results:
  • First patient (29-year-old man): disease progressed in several organs outside the operated area 14 months after surgery
  • First patient: died at the 24th postoperative month (the discussion gives the twenty-second month) but remained free of disease at the site of surgery in the left chest
  • Second patient (woman, 64 in the case description, 54 in the article's abstract): a chest wall relapse was detected in the forty-third month after EPP and was treated by partial resection of the second and third ribs
  • Second patient: alive and disease-free at the twelfth month of her third surgical follow-up
• The authors' conclusion: The authors concluded that EPP could be considered as salvage treatment in selected patients with intrathoracic sarcomas not amenable to other therapies. They added that it can achieve mid- to long-term disease control even in the case of advanced spread.

Topics

Medical terms in this study, explained in our Lexicon: Extrapleural Pneumonectomy (EPP), Sarcoma, Pleural Mesothelioma, Pleural Effusion, Intrathoracic.

Related studies

• Effusion cytology after extrapleural pneumonectomy for treatment of malignant mesothelioma — A.A. Renshaw, D. Nappi, et al. (1997)
• Patterns of failure, toxicity, and survival after extrapleural pneumonectomy and hemithoracic intensity-modulated radiation therapy for malignant pleural mesothelioma — D.R. Gomez, D.S. Hong, et al. (2013)
• Extrapleural pneumonectomy for early stage malignant pleural mesothelioma: a harmful procedure — O. Rena, C. Casadio (2012)
• Second surgery for recurrence of malignant pleural mesothelioma after extrapleural pneumonectomy — L. Politi, G. Borzellino (2010)
• Interim results of pleurectomy/decortication and intraoperative intrapleural hyperthermic cisplatin perfusion for patients with malignant pleural mesothelioma intolerable to extrapleural pneumonectomy — H. Ishibashi, M. Kobayashi, et al. (2015)
• Pattern of failure after adjuvant radiotherapy following extrapleural pneumonectomy of pleural mesothelioma in the SAKK 17/04 trial — O. Riesterer, I.F. Ciernik, et al. (2019)

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