Iterative surgery for recurrent malignant pleural mesothelioma in long-term survivor

Our plain-English summary of Iterative surgery for recurrent malignant pleural mesothelioma in long-term survivor, by G. Leuzzi, E. Melis, D. Forcella, et al (ANZ Journal of Surgery, 2017).

The study

• Authors: G. Leuzzi, E. Melis, D. Forcella, F. Facciolo
• Journal: ANZ Journal of Surgery
• Published: 2017;87(11):946-947
• Type of article: Case report
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This is a case report of one patient treated at a thoracic surgery unit in Rome, Italy. The patient, a 55-year-old Caucasian woman, had previously undergone extrapleural pneumonectomy for epithelioid malignant pleural mesothelioma, staged pT2N0M0, followed by radiotherapy. Seven years later, a PET-CT scan showed a 2.5 cm lesion in the upper mediastinum with intense uptake (SUVmax 9.8) and no sign of disease outside the chest. Because radiotherapy had already been given at a therapeutic dose, it was not repeated. Instead, the lymph node was removed surgically through a left transmanubrial approach, without complications. Pathology confirmed a recurrence of epithelioid mesothelioma, and chemotherapy followed. Two years after this second operation, the patient was alive and disease-free. The authors concluded that, in selected fit patients with a long disease-free interval and a localized recurrence, repeat surgery may be a feasible treatment option. The report does not describe any asbestos exposure. A single case shows what happened to one person, not how often such treatment works.

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 (single patient, published as an 'Images for Surgeons' item)
• Who was studied: One 55-year-old Caucasian woman treated at the Thoracic Surgery Unit, Regina Elena National Cancer Institute, Rome, Italy. She had a mediastinal lymph node enlargement found 7 years after extrapleural pneumonectomy and adjuvant radiotherapy for epithelioid malignant pleural mesothelioma staged pT2N0M0. No dates of treatment are given.
• Main results:
  • In this patient, a PET-CT scan showed a round 2.5 cm lesion in the left prevascular region of the upper mediastinum with intense uptake (SUVmax 9.8), suggestive of nodal recurrence, with no sign of extrathoracic disease.
  • Radiotherapy was not given because the patient had already received a therapeutic dose for the primary tumour. The lymph node was removed surgically through a left transmanubrial approach without complications.
  • Final pathology was consistent with recurrence of epithelioid malignant pleural mesothelioma, and the patient then received chemotherapy.
  • Two years after the second surgery, the patient was alive and disease-free.
• The authors' conclusion: The authors concluded that in selected fit patients with a long disease-free interval and localized recurrence, iterative (repeat) surgery may be a feasible treatment option. They added that when radiotherapy is contraindicated for relapse control, surgery with radical intent should be considered as part of multimodality treatment.

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.

Related studies

• Iterative cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for recurrent peritoneal metastases — T.C. Chua, L.E. Quinn, et al. (2013)
• The long-term morbidity of pleuroperitoneal shunts in the management of recurrent malignant effusions — O. Genc, M. Petrou, et al. (2000)
• Iterative procedures combining cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for isolated peritoneal recurrence — M. Vaira, M. Robella, et al. (2014)
• Iterative cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for recurrent or progressive diffuse malignant peritoneal mesothelioma: clinicopathologic characteristics and survival outcome — C. Ihemelandu, L. Bijelic, et al. (2015)
• Percutaneous Cryoablation for the Treatment of Recurrent Malignant Pleural Mesothelioma: Safety, Early-Term Efficacy, and Predictors of Local Recurrence — F. Abtin, M.T. Quirk, et al. (2017)
• Recurrent peritoneal mesothelioma with long-delayed recurrence — A. Tandar, G. Abraham, et al. (2001)

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