Techniques of surgery and radiotherapy for multimodal treatment of pleural mesothelioma

Our plain-English summary of Techniques of surgery and radiotherapy for multimodal treatment of pleural mesothelioma, by P. Bonnette (Journal of Thoracic Oncology, 2011).

The study

• Author: P. Bonnette
• Journal: Journal of Thoracic Oncology
• Published: 2011;6(12):2146
• Type of article: Letter
• Read it: PubMed · Publisher

In plain English

This item is a short letter to the editor, not a full research report. The author, from a department of thoracic surgery at Hôpital Foch in Suresnes, France, commented on recent articles about surgery and radiotherapy for pleural mesothelioma. The author described a consecutive series of 15 patients who had extrapleural pneumonectomy with the pericardium and diaphragm preserved. The aim was to avoid seeding the tumor into the abdomen or the pericardium. There were no postoperative deaths. Over the previous 4 years, laparoscopy was done one week before surgery. In 10 laparoscopies, 3 peritoneal invasions were found, and those patients did not have the operation. The last five patients received helical tomotherapy, a form of intensity-modulated radiotherapy. The author stated that preserving the diaphragm and pericardium seemed to make the postoperative course easier without more recurrences in those areas, but gave no recurrence figures or follow-up time. In the author's opinion, this strategy should minimize postoperative deaths, local recurrences, and peritoneal and contralateral pleural seeding.

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 describing the author's own consecutive surgical series
• Who was studied: a consecutive series of 15 patients with pleural mesothelioma treated by extrapleural pneumonectomy at the author's hospital (Hôpital Foch, Suresnes, France); no dates given apart from 'the last 4 years' for preoperative laparoscopy
• Exposure: No asbestos exposure is described. The letter concerns treatment: extrapleural pneumonectomy with preservation of the pericardium and diaphragm, preoperative laparoscopy, contralateral thoracoscopy and mediastinoscopy, and postoperative radiotherapy (helical tomotherapy in the last five patients).
• Main results:
  • Among the 15 patients in the series, there were no postoperative deaths.
  • During the last 4 years, 10 laparoscopies were performed before planned surgery. They detected 3 peritoneal invasions, and those patients were excluded from resection.
  • Helical tomotherapy was adopted for the last five patients in the series.
  • The author stated that preserving the diaphragm and pericardium seemed to make the postoperative course easier without an increase in recurrences in these areas (no figures given).
• The authors' conclusion: In the author's opinion, this strategy should minimize postoperative mortality, local recurrences, and peritoneal and contralateral pleural seeding.

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.

Related studies

• Mesothelioma at era of helical tomotherapy: results of two institutions in combining chemotherapy, surgery and radiotherapy — A. Sylvestre, M.A. Mahé, et al. (2011)
• Multimodal treatment for malignant pleural mesothelioma — R.C. Rintoul, T. Treasure, et al. (2015)
• Surgery for malignant pleural mesothelioma after radiotherapy (SMART): final results from a single-centre, phase 2 trial — B.C.J. Cho, L. Donahoe, et al. (2021)
• Intensity-modulated radiotherapy after extrapleural pneumonectomy in the combined-modality treatment of malignant pleural mesothelioma — A. Chi, Z. Liao, et al. (2011)
• Surgery in the treatment of malignant pleural mesothelioma: recruitment into trials should be the default position — A. Datta, R. Smith, et al. (2014)
• Surgery as part of radical treatment for malignant pleural mesothelioma — D.A. Waller, S. Tenconi (2017)

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