Lung-sparing total pleurectomy: the surgical option of choice in malignant pleural mesothelioma?

Our plain-English summary of Lung-sparing total pleurectomy: the surgical option of choice in malignant pleural mesothelioma?, by D.A. Waller (European Journal of Cardio-thoracic Surgery, 2013).

The study

• Author: D.A. Waller
• Journal: European Journal of Cardio-thoracic Surgery
• Published: 2013;44(1):123-4
• Type of article: Comment
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This was an editorial comment, not a new study. It was written by a thoracic surgeon at Glenfield Hospital in Leicester, UK, about a paper by Bölükbas and colleagues in the same journal issue on lung-sparing surgery for malignant pleural mesothelioma. The article did not discuss asbestos exposure. The author described a shift in specialist surgical opinion away from extrapleural pneumonectomy towards lung-sparing surgery. The author noted that Bölükbas and colleagues reported 28% 5-year survival in 42 patients with IMIG Stage III disease, and that macroscopic complete resection was not achieved in 16 of the 42. The author was a co-investigator of the MARS trial. The author wrote that MARS was a feasibility study never powered to show a survival difference, and that its results had been overinterpreted. The author concluded that, in the majority of cases, lung-sparing pleurectomy appears to be the surgical option of choice, while extrapleural pneumonectomy may be needed where tumour invasion prevents sparing the lung. The author also proposed the name 'lung-sparing total pleurectomy' for this operation when macroscopic tumour clearance is achieved.

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: Editorial comment (opinion piece commenting on another article; no original data)
• Who was studied: No study population of its own. The editorial comments on the Bölükbas et al. series of 42 patients with IMIG Stage III malignant pleural mesothelioma.
• Main results:
  • Reported by Bölükbas et al. (the paper under comment), not by this editorial: 28% 5-year survival in 42 patients with IMIG Stage III malignant pleural mesothelioma after lung-sparing surgery.
  • Reported by Bölükbas et al., as described by the author: macroscopic complete resection was not achieved in 16 of the 42 patients.
  • The author described a shift in specialist surgical opinion away from extrapleural pneumonectomy (EPP) towards lung-sparing surgery.
  • The author, a MARS co-investigator, stated that the MARS trial was a feasibility study never powered to show a survival difference between EPP and no EPP, and that its results had been overinterpreted.
  • The author stated that EPP may be needed where tumour invasion precludes lung sparing.
  • The author proposed the term 'lung-sparing total pleurectomy' for this operation, on the condition that macroscopic tumour clearance is achieved.
• The authors' conclusion: The author concluded that in the majority of cases lung-sparing pleurectomy appears to be the surgical option of choice.

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

• Factors predicting poor survival after lung-sparing radical pleurectomy of IMIG stage III malignant pleural mesothelioma — S. Bölükbas, M. Eberlein, et al. (2013)
• Optimal gross tumor volume definition in lung-sparing intensity modulated radiotherapy for pleural mesothelioma: an in silico study — A. Botticella, G. Defraene, et al. (2016)
• Non-incisional pleurectomy-decortication for malignant pleural mesothelioma — F. Tanaka, N. Imanishi, et al. (2018)
• Long-term survival after lung-sparing total pleurectomy for locally advanced (International Mesothelioma Interest Group Stage T3-T4) non-sarcomatoid malignant pleural mesothelioma — A. Nakas, E. von Meyenfeldt, et al. (2012)
• Improved Outcomes with Modern Lung-Sparing Trimodality Therapy in Patients with Malignant Pleural Mesothelioma — F. Shaikh, M.G. Zauderer, et al. (2017)
• The state of the art in the technical performance of lung-sparing operations for malignant pleural mesothelioma — J.S. Friedberg (2013)

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