Surgical Strategy for Malignant Pleural Mesothelioma: Where Are We Going and What Are We Missing?

Our plain-English summary of Surgical Strategy for Malignant Pleural Mesothelioma: Where Are We Going and What Are We Missing?, by F. Lococo, M. Paci, T. Ricchetti, et al (The Annals of Thoracic Surgery, 2015).

The study

• Authors: F. Lococo, M. Paci, T. Ricchetti, C. Rapicetta, C. Carbonelli, P. Ciammella, F. Zanelli, A. Filice, G. Sgarbi, A. Cesario
• Journal: The Annals of Thoracic Surgery
• Published: 2015;100(2):769-70
• Type of article: Letter, Comment
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This is a letter to the editor, not a research study. It reported no new patient data and did not discuss asbestos exposure. The authors commented on an earlier article by Spaggiari and coworkers. That article described results of extrapleural pneumonectomy (EPP), an operation for malignant pleural mesothelioma, in 573 patients from several institutions. According to the letter, the earlier series reported a median overall survival of 18 months and a 5-year survival of 15%. It also reported major complications in 26.3% of patients and deaths in 6.9% after surgery. The authors argued that its conclusions should be interpreted with caution because only surgically treated patients were included in an uncontrolled analysis. They cited another group's analysis of 1,363 surgical and nonsurgical cases. That group concluded that patients with good prognostic factors had similar survival with medical therapy only, pleurectomy/decortication, or EPP. The authors stated that quality of life should be investigated in detail before drawing conclusions about the efficacy of surgery. They noted that the Spaggiari article gave no such data.

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 (correspondence) commenting on a previously published multicenter study; no original data
• Who was studied: No patients were studied by the letter's authors. The letter discussed an earlier multi-institutional series by Spaggiari and coworkers of 573 patients who had EPP for malignant pleural mesothelioma.
• Exposure: Not about asbestos exposure. The letter concerned surgical treatment of malignant pleural mesothelioma: extrapleural pneumonectomy (EPP) versus pleurectomy/decortication (P/D) or other lung-sparing procedures.
• Main results:
  • Not this letter's own finding. The letter reported that the earlier Spaggiari study found median, 2-, 3-, and 5-year overall survival after EPP of 18 months, 41%, 27%, and 15%, respectively.
  • Not this letter's own finding. The letter reported that, in the Spaggiari study, postoperative major complications occurred in 26.3% of patients and deaths in 6.9%.
  • The authors criticized the Spaggiari study for including only surgically treated patients in an uncontrolled analysis, which they said may lead to unjustified emphasis in interpreting the results.
  • Not this letter's own finding. The letter cited other authors who analyzed 1,363 surgical and nonsurgical MPM cases and concluded that patients with good prognostic factors had similar survival with medical therapy only, P/D, or EPP.
  • The authors noted that the Spaggiari article provided no data on quality of life.
• The authors' conclusion: The authors believed caution should be taken in interpreting the Spaggiari study's conclusions. They stated that a detailed investigation of the impact of surgery on quality of life is, in their opinion, very important for reaching a conclusion on its efficacy.

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

• What is the optimum strategy for thromboembolic prophylaxis following extrapleural pneumonectomy in patients with malignant pleural mesothelioma? — A. Billè, L. Okiror, et al. (2012)
• Multimodal management of malignant pleural mesothelioma: where are we today? — P.E. Van Schil, I. Opitz, et al. (2014)
• Should we continue to offer extrapleural pneumonectomy to selected mesothelioma patients? A single center experience comparing surgical and non-surgical management — M. Baud, A. Bobbio, et al. (2014)
• Trimodality strategy for treating malignant pleural mesothelioma: results of a feasibility study of induction pemetrexed plus cisplatin followed by extrapleural pneumonectomy and postoperative hemithoracic radiation (Japan Mesothelioma Interest Group 0601 Trial) — S. Hasegawa, M. Okada, et al. (2016)
• The Rochdale asbestos cancer studies and the politics of epidemiology: what you see depends on where you sit — G. Tweedale (2007)
• A systematic review and meta-analysis of surgical treatments for malignant pleural mesothelioma — C. Cao, D. Tian, et al. (2014)

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