Extrapleural Pneumonectomy And A Pleurectomy With Irradiation

Extrapleural Pneumonectomy And A Pleurectomy With Irradiation

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Another interesting study is called, Pleural Mesothelioma by N Martini, PM McCormack, MS Bains, LR Kaiser, ME Burt and BS Hilaris - The Annals of Thoracic Surgery, Vol 43, 113-120. Here is an excerpt: Pleural mesotheliomas are uncommon tumors. Correct diagnosis of the benign variant is rarely made preoperatively, and resection is the treatment of choice and is curative. Malignant pleural mesotheliomas are locally aggressive and difficult to treat. They may be seen clinically as localized pleural tumors or as diffuse pleural disease with effusion and encasement of the lung and obliteration of the pleural space. The localized forms of malignant mesotheliomas are fibrosarcomatous. Their diagnosis and treatment do not differ from those for soft-part sarcomas seen elsewhere. Wide en-bloc excision is the treatment of choice and can be curative. The diffuse forms of malignant mesotheliomas are mainly epithelial. Treatment is generally unsatisfactory, and long-term survival is rare. Two surgical approaches are currently available: an extrapleural pneumonectomy and a pleurectomy with irradiation. The authors favor the latter approach because of its wider applicability, lower morbidity rate, and better survival advantage. Steps in selecting the best surgical mode of treatment are presented.

Another interesting study is called, Second-line (post-study) chemotherapy received by patients treated in the phase III trial of pemetrexed plus cisplatin versus cisplatin alone in malignant pleural Mesothelioma - Ann Oncol (June 2005) 16 (6): 923-927 by C. Manegold, J. Symanowski, U. Gatzemeier, M. Reck, J. von Pawel, C. Kortsik, K. Nackaerts, P. Lianes and N. J. Vogelzang Here is an excerpt: Abstract - Background: A phase III trial in patients with malignant pleural mesothelioma demonstrated a survival advantage for pemetrexed plus cisplatin compared with single-agent cisplatin. Because post-study chemotherapy (PSC) may have influenced the outcome of the trial, we examined its use and association with survival. Patients and methods:: Eighty-four patients from the pemetrexed plus cisplatin arm and 105 patients from the single-agent cisplatin arm received PSC. KaplanMeier survival estimates were compared by treatment groups, and by PSC and non-PSC subgroups. Results: The percentage of patients receiving PSC was imbalanced between the treatment arms. Fewer pemetrexed plus cisplatin treated patients received PSC (37.2% versus 47.3%). A multiple regression analysis performed in this trial showed that PSC had a statistically significant correlation with prolonged survival (P

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