Malignant pleural mesothelioma: a therapeutic challenge

Our plain-English summary of Malignant pleural mesothelioma: a therapeutic challenge, by G. Dimitrakakis, T. BinEsmael, A. Szafranek, et al (Interactive Cardiovascular and Thoracic Surgery, 2011).

The study

• Authors: G. Dimitrakakis, T. BinEsmael, A. Szafranek, P.A. O'Keefe
• Journal: Interactive Cardiovascular and Thoracic Surgery
• Published: 2011;13(6):691-2
• Type of article: Comment
• Read it: PubMed · Publisher

In plain English

This is not an original study. It is a short commentary (an "eComment") by surgeons at the University Hospital of Wales, Cardiff, responding to an article by Tokunaga et al. on treating malignant pleural mesothelioma. It was published as an erratum because the publisher had left it out. The comment presented no new patients or data. Instead it restated results from an earlier study from the authors' department by Luckraz and colleagues, which reviewed 139 patients operated on over 30 years. That study gave a 30-day death rate after surgery of 1.1% for pleurectomy and decortication and 8.2% for extra-pleural pneumonectomy. In that study, extra-pleural pneumonectomy was an independent risk factor for shorter survival (hazard ratio 9.2). The comment also cited a separate study by Flores et al. of 663 patients. Asbestos was not discussed. The authors concluded that overall survival of these patients remains poor. They also wrote that proposing a therapy as promising needs a large number of patients. Where numbers are too small, they described a properly designed multi-institutional trial with a randomized control group as a good option.

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: Commentary (eComment) on another published article, printed as an erratum; no new patient data
• Who was studied: No population of its own. The comment cited an earlier retrospective analysis by Luckraz and colleagues of 139 patients who had surgery for malignant pleural mesothelioma in the authors' department (Cardiff) over 30 years.
• Main results:
  • Cited from Luckraz et al. (not new data): 49 patients had extra-pleural pneumonectomy (EPP) and 90 had pleurectomy and decortication (PD).
  • Cited from Luckraz et al.: 30-day post-operative mortality was 1.1% in the PD group and 8.2% in the EPP group. The P value is printed as "P=0.03%".
  • Cited from Luckraz et al.: the longest survival was in the PD group with combined postoperative treatment and radiotherapy (as worded), median 26 months.
  • Cited from Luckraz et al.: in multivariate analysis, EPP was an independent risk factor for decreased survival (hazard ratio 9.2).
  • Cited from Luckraz et al.: the epithelial type of mesothelioma showed better survival (P=0.002).
  • Cited from Luckraz et al.: Butchart stage did not influence long-term survival (P=0.78).
  • Cited from a separate multi-institutional study by Flores et al. of 663 patients: operative mortality was 7% for EPP and 4% for PD.
• The authors' conclusion: The authors concluded that, although surgery aims at complete resection with adjuvant therapy to improve survival, overall survival of these patients remains poor. They added that proposing promising therapies needs a large number of patients. When patient volume is not large enough, they called a properly designed multi-institutional trial a good option.

Topics

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

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma.

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