Reply to the editor

Our plain-English summary of Reply to the editor, by M. Baud, P. Forgez, D. Damotte, et al (The Journal of Thoracic and Cardiovascular Surgery, 2013).

The study

• Authors: M. Baud, P. Forgez, D. Damotte, M. Alifano
• Journal: The Journal of Thoracic and Cardiovascular Surgery
• Published: 2013;146(4):990-1
• Type of article: Letter, Comment
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This is a letter to the editor reporting no new data. The authors replied to a letter from Dr Acton suggesting that talc pleurodesis might protect against mesothelioma. The authors wrote that the outlook for malignant pleural mesothelioma not treated by surgery remains poor. They stated that talc used for pleurodesis is asbestos free and is used mainly for malignant effusion and, to a lesser extent, pneumothorax. They stated that no cases of lung cancer or mesothelioma have been reported after it. They knew of no precise count of long-lived patients treated this way and were not fully convinced by Dr Acton's estimate of hundreds of thousands. Given an annual mesothelioma incidence of about 1.5 per 100,000, they wrote that the lack of documented cases still suggests some considerations. They cited others' laboratory experiments that, they wrote, suggested talc induced significant apoptosis (cell death) in malignant mesothelioma and lung adenocarcinoma cells but not in normal pleural mesothelial cells. The authors concluded that preclinical studies in asbestos-related nonneoplastic pleural disease would be interesting, though suitable nonhuman models remain to be determined.

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 (authors' reply to a letter commenting on their article); no new data
• Exposure: talc pleurodesis, which the authors described as asbestos-free talc with large particles, used mainly for malignant effusion and, to a lesser extent, pneumothorax
• Main results:
  • The authors stated that the prognosis of malignant pleural mesothelioma not treated by surgery remains poor.
  • The authors stated that no cases of lung cancer or mesothelioma have been reported after talc pleurodesis.
  • The authors stated that talc pleurodesis is used mainly for malignant effusion and, to a lesser extent, pneumothorax.
  • The authors were not fully convinced by Dr Acton's estimate of hundreds of thousands of long-lived patients treated with talc pleurodesis.
  • The authors set the annual incidence of mesothelioma at approximately 1.5 per 100,000 against the absence of documented mesothelioma cases in patients treated with talc pleurodesis.
  • The authors wrote that the lack of documented mesothelioma cases in patients treated by talc pleurodesis still suggests some considerations.
  • The authors cited earlier in vitro (laboratory) experiments by others which, in their words, suggested that talc at a therapeutically achievable concentration induced significant apoptosis in malignant mesothelioma and lung adenocarcinoma cells, but not in normal pleural mesothelial cells. These were not findings of this letter.
• The authors' conclusion: The authors concluded that preclinical studies of talc's effects in asbestos-related nonneoplastic pleural disease would be interesting, to assess whether talc might prevent evolution toward mesothelioma.
• Limitations the authors state:
  • The authors knew of no precise estimate of the number of patients with long life expectancy treated by talc pleurodesis.
  • The authors stated that appropriate nonhuman models for such studies remain to be determined.

Topics

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

Related studies

• Outcome and prognostic factors of pleural mesothelioma after surgical diagnosis and/or pleurodesis — M. Baud, S. Strano, et al. (2013)
• Thoracoscopic palliative treatment of malignant pleural effusions: results in 273 patients — K. Arapis, R. Caliandro, et al. (2006)
• MesoTRAP: a feasibility study that includes a pilot clinical trial comparing video-assisted thoracoscopic partial pleurectomy decortication with indwelling pleural catheter in patients with trapped lung due to malignant pleural mesothelioma designed to address recruitment and randomisation uncertainties and sample size requirements for a phase III trial — C. Matthews, C. Freeman, et al. (2019)
• Video-assisted management of malignant pleural effusion in breast carcinoma — R. Gasparri, F. Leo, et al. (2006)
• The dog didn't bark — V. Acton (2013)
• Reply to the editor — W.T. Vigneswaran (2014)

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