Reply: To PMID 24726598

Our plain-English summary of Reply: To PMID 24726598, by L. Spaggiari, G. Marulli, G.L. Pariscenti, et al (The Annals of Thoracic Surgery, 2015).

The study

• Authors: L. Spaggiari, G. Marulli, G.L. Pariscenti, M. Alloisio, P. Fontana, A. Oliaro, G.B. Ratto, F. Facciolo, F. Mucilli, M. Casiraghi, F. Rea
• Journal: The Annals of Thoracic Surgery
• Published: 2015;100(2):770-1
• Type of article: Letter, Comment
• Read it: PubMed · Publisher

In plain English

This item is a letter to the editor, not a research study. The authors, a group of Italian thoracic surgeons, replied to a letter by Lococo and colleagues about the authors' 2014 article on extrapleural pneumonectomy (EPP), an operation for malignant pleural mesothelioma. The authors explained that their earlier multicenter study covered nine Italian referral centers that each performed more than 25 EPPs in the previous 10 years. They said its aim was to identify factors that predict survival, to help select patients for EPP. They said it did not compare EPP with other operations such as pleurectomy/decortication. They restated that the earlier study found longer survival after surgery in patients with epithelial tumors, patients with stage 0/1 disease, and younger women, with estimated 2-year survival up to 68%, especially as part of trimodality treatment. They acknowledged that the study's retrospective design was an important bias. They noted that the only randomized trial, the MARS study, reported morbidity of 69% and mortality of 19%. The authors concluded that the letter writer had misread their article. 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 (author reply to correspondence about the authors' 2014 multicenter retrospective study); not original research
• Who was studied: No new population. The letter describes the authors' earlier study, carried out at nine Italian referral centers for thoracic surgery that each performed more than 25 EPPs in the previous 10 years.
• Exposure: Asbestos exposure is not discussed. The subject is a surgical treatment: extrapleural pneumonectomy (EPP) for malignant pleural mesothelioma, and how to select patients for it.
• Main results:
  • The authors restated a finding of their earlier 2014 study, not new data: patients with epithelial tumors, patients with stage 0/1 disease, and younger women had longer survival after surgery.
  • Also restated from the earlier study: estimated 2-year survival was up to 68%, especially when surgery was part of trimodality treatment.
  • The authors cited a different study, the MARS randomized trial. They said it reported morbidity of 69% and mortality of 19%, which they described as higher than in the literature.
• The authors' conclusion: The authors stated that their earlier study assessed prognostic factors for selecting EPP candidates and did not compare EPP with other surgical approaches. They concluded that the letter writer should have read their article more carefully.
• Limitations the authors state:
  • The authors acknowledged that an important bias of their earlier study was its retrospective design. They said a randomized trial is difficult because this tumor is rare and heterogeneous.

Topics

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

Related studies

• Extrapleural pneumonectomy for malignant mesothelioma: an Italian multicenter retrospective study — L. Spaggiari, G. Marulli, et al. (2014)
• Prognostic Score of Long-Term Survival After Surgery for Malignant Pleural Mesothelioma: A Multicenter Analysis — G. Leuzzi, F. Rea, et al. (2015)
• Reply: To PMID 25534527 — R.M. Flores, E. Taioli, et al. (2015)
• Reply: To PMID 25534527 — E. Taioli, A.S. Wolf, et al. (2015)
• Hemithoracic radiotherapy for mesothelioma: lack of benefit or lack of statistical power? - Authors' reply — O. Riesterer, W. Weder, et al. (2016)
• In reply to L. Ceresoli et al. "Adjuvant radiotherapy for malignant pleural mesothelioma: challenges and pitfalls" — S. Tonoli, S. Magrini, et al. (2012)

Browse more research in The Annals of Thoracic Surgery, or return to medical research.