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Malignant Pleural Mesothelioma: Patient Selection for Extrapleural Pneumonectomy

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Difficult Decisions in Thoracic Surgery

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Abstract

The selection of patients with malignant pleural mesothelioma (MPM) for extrapleural pneumonectomy (EPP) can be considered in two areas: resectability and operability. Resectability refers to the ability to achieve macroscopic tumor clearance. Operability refers to the patient’s fitness to tolerate the operation.

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References

  1. Rusch VW, Godwin JD, Shuman WP. The role of computed tomography scanning in the initial assessment and the follow-up of malignant pleural mesothelioma. J Thorac Cardiovasc Surg. 1988;96:171–177.

    PubMed  CAS  Google Scholar 

  2. Heelan RT, Rusch VW, Begg CB, Panicek DM, Caravelli JF, Eisen C. Staging of malignant pleural mesothelioma: comparison of CT and MR imaging. AJR Am J Roentgenol. 1999;172:1039–1047.

    Article  PubMed  CAS  Google Scholar 

  3. Stewart D, Waller D, Edwards J, Jeyapalan K, Entwisle J. Is there a role for pre-operative contrast-enhanced magnetic resonance imaging for radical surgery in malignant pleural mesothelioma? Eur J Cardiothorac Surg. 2003;24:1019–1024.

    Article  PubMed  Google Scholar 

  4. Flores RM, Akhurst T, Gonen M, Larson SM, Rusch VW Positron emission tomography defines metastatic disease but not locoregional disease in patients with malignant pleural mesothelioma. J Thorac Cardiovasc Surg. 2003;126:11–16.

    Article  PubMed  Google Scholar 

  5. Flores RM, Akhurst T, Gonen M, Zakowski M, Dycoco J, Larson SM, Rusch VW Positron emission tomography predicts survival in malignant pleural mesothelioma. J Thorac Cardiovasc Surg. 2006;132:763–768.

    Article  PubMed  Google Scholar 

  6. Pilling JE, Stewart DJ, Martin-Ucar AE, Muller S, O’Byrne KJ, Waller DA. The case for routine cervical mediastinoscopy prior to radical surgery for malignant pleural mesothelioma. Eur J Cardiothorac Surg. 2004;25:497–501.

    Article  PubMed  CAS  Google Scholar 

  7. Rice DC, Steliga MA, Stewart J, Eapen G, Jimenez CA, Lee JH, Hofstetter WL, Marom EM, Mehran RJ, Vaporciyan AA, Walsh GL, Swisher SG. Endoscopic ultrasound-guided fine needle aspiration for staging of malignant pleural mesothelioma. Ann Thorac Surg. 2009;88:862–868.

    Article  PubMed  Google Scholar 

  8. de Perrot M, Uy K, Anraku M, Tsao MS, Darling G, Waddell TK, Pierre AF, Bezjak A, Keshavjee S, Johnston MR. Impact of lymph node metastasis on outcome after extrapleural pneumonectomy for malignant pleural mesothelioma. J Thorac Cardiovasc Surg. 2007;133:111–116.

    Article  PubMed  Google Scholar 

  9. Edwards JG, Stewart DJ, Martin-Ucar A, Muller S, Richards C, Waller DA. The pattern of lymph node involvement influences outcome after extrapleural pneumonectomy for malignant mesothelioma. J Thorac Cardiovasc Surg. 2006;131:981–987.

    Article  PubMed  Google Scholar 

  10. Sugarbaker DJ, Flores RM, Jaklitsch MT, Richards WG, Strauss GM, Corson JM, DeCamp MM Jr, Swanson SJ, Bueno R, Lukanich JM, Baldini EH, Mentzer SJ. Resection margins, extrapleural nodal status, and cell type determine postoperative long-term survival in trimodality therapy of malignant pleural mesothelioma: results in 183 patients. J Thorac Cardiovasc Surg. 1999;117:54–63.

    Article  PubMed  CAS  Google Scholar 

  11. Flores RM, Routledge T, Seshan VE, Dycoco J, Zakowski M, Hirth Y, Rusch VW The impact of lymph node station on survival in 348 patients with surgically resected malignant pleural mesothelioma: implications for revision of the American Joint Committee on Cancer staging system. J Thorac Cardiovasc Surg. 2008;136:605–610.

    Article  PubMed  Google Scholar 

  12. Martin-Ucar AE, Nakas A, Edwards JG, Waller DA. Case-control study between extrapleural pneumonectomy and radical pleurectomy/decortication for pathological N2 malignant pleural mesothelioma. Eur J Cardiothorac Surg. 2007;31:765–770.

    Article  PubMed  Google Scholar 

  13. Flores RM, Pass HI, Seshan VE, Dycoco J, Zakowski M, Carbone M, Bains MS, Rusch VW. Extrapleural pneumonectomy versus pleurectomy/decortication in the surgical management of malignant pleural mesothelioma: results in 663 patients. J Thorac Cardiovasc Surg. 2008;135:620–626.

    Article  PubMed  Google Scholar 

  14. Pass HI, Temeck BK, Kranda K, Steinberg SM, Feuerstein IR. Preoperative tumor volume is associated with outcome in malignant pleural mesothelioma. J Thorac Cardiovasc Surg. 1998;115:310–317.

    Article  PubMed  CAS  Google Scholar 

  15. Rice DC, Erasmus JJ, Stevens CW, Vaporciyan AA, Wu JS, Tsao AS, Walsh GL, Swisher SG, Hofstetter WL, Ordonez NG, Smythe WR. Extended surgical staging for potentially resectable malignant pleural mesothelioma. Ann Thorac Surg. 2005;80:1988–1992.

    Article  PubMed  Google Scholar 

  16. Alvarez JM, Hasani A, Segal A, Sterret G, Millward M, Nowak A, Musk W, Bydder S. Bilateral thoracoscopy, mediastinoscopy and laparoscopy, in addition to CT, MRI and PET imaging, are essential to correctly stage and treat patients with mesothelioma prior to trimodality therapy. ANZ J Surg. 2009;79:734–738.

    Article  PubMed  Google Scholar 

  17. Weder W, Stahel RA, Bernhard J, Bodis S, Vogt P, Ballabeni P, Lardinois D, Betticher D, Schmid R, Stupp R, Ris HB, Jermann M, Mingrone W, Roth AD, Spiliopoulos A. Multicenter trial of neo-adjuvant chemotherapy followed by extrapleural pneumonectomy in malignant pleural mesothelioma. Ann Oncol. 2007;18:1196–1202.

    Article  PubMed  CAS  Google Scholar 

  18. Yan TD, Boyer M, Tin MM, Sim J, Kennedy C, McLean J, Bannon PG, McCaughan BC. Prognostic features of long-term survivors after surgical management of malignant pleural mesothelioma. Ann Thorac Surg. 2009;87:1552–1556.

    Article  PubMed  Google Scholar 

  19. Balduyck B, Trousse D, Nakas A, Martin-Ucar AE, Edwards J, Waller DA. Therapeutic surgery for nonepithelioid malignant pleural mesothelioma: is it really worthwhile? Ann Thorac Surg. 2010;89:907–911.

    Article  PubMed  Google Scholar 

  20. Krug LM, Pass HI, Rusch VW, Kindler HL, Sugarbaker DJ, Rosenzweig KE, Flores R, Friedberg JS, Pisters K, Monberg M, Obasaju CK, Vogelzang NJ. Multicenter phase II trial of neoadjuvant pemetrexed plus cisplatin followed by extrapleural pneumonectomy and radiation for malignant pleural mesothelioma. J Clin Oncol. 2009;27:3007–3013.

    Article  PubMed  CAS  Google Scholar 

  21. Creaney J, Yeoman D, Demelker Y, Segal A, Musk AW, Skates SJ, Robinson BW. Comparison of osteopontin, megakaryocyte potentiating factor, and mesothelin proteins as markers in the serum of patients with malignant mesothelioma. J Thorac Oncol. 2008;3:851–857.

    Article  PubMed  Google Scholar 

  22. Gordon GJ, Dong L, Yeap BY, Richards WG, Glickman JN, Edenfield H, Mani M, Colquitt R, Maulik G, Van Oss B, Sugarbaker DJ, Bueno R. Four-gene expression ratio test for survival in patients undergoing surgery for mesothelioma. J Natl Cancer Inst. 2009;101:678–686.

    Article  PubMed  CAS  Google Scholar 

  23. Colice GL, Shafazand S, Griffin JP, Keenan R, Bolliger CT; American College of Chest Physicians. Physiologic evaluation of the patient with lung cancer being considered for resectional surgery: ACCP evidenced-based clinical practice guidelines (2nd edition). Chest. 2007;132(3 Suppl):161S–177S.

    Article  PubMed  Google Scholar 

  24. Win T, Tasker AD, Groves AM, White C, Ritchie AJ, Wells FC, Laroche CM. Ventilation-perfusion scintigraphy to predict postoperative pulmonary function in lung cancer patients undergoing pneumonectomy. AJR Am J Roentgenol. 2006;187:1260–1265.

    Article  PubMed  Google Scholar 

  25. Sugarbaker DJ, Jaklitsch MT, Bueno R, Richards W, Lukanich J, Mentzer SJ, Colson Y, Linden P, Chang M, Capalbo L, Oldread E, Neragi-Miandoab S, Swanson SJ, Zellos LS. Prevention, early detection, and management of complications after 328 consecutive extrapleural pneumonectomies. J Thorac Cardiovasc Surg. 2004;128:138–146.

    Article  PubMed  Google Scholar 

  26. Stewart DJ, Martin-Ucar AE, Edwards JG, West K, Waller DA. Extra-pleural pneumonectomy for malignant pleural mesothelioma: the risks of induction chemotherapy, right-sided procedures and prolonged operations. Eur J Cardiothorac Surg. 2005;27:373–378.

    Article  PubMed  Google Scholar 

  27. Hillerdal G, Sorensen JB, Sundström S, Riska H, Vikström A, Hjerpe A. Treatment of malignant pleural mesothelioma with carboplatin, liposomized doxorubicin, and gemcitabine: a phase II study. J Thorac Oncol. 2008;3:1325–1331.

    Article  PubMed  Google Scholar 

  28. Treasure T, Waller D, Tan C, Entwisle J, O’Brien M, O’Byrne K, Thomas G, Snee M, Spicer J, Landau D, Lang-Lazdunski L, Bliss J, Peckitt C, Rogers S, Marriage Nee Denholm E, Coombes G, Webster-Smith M, Peto J. The mesothelioma and radical surgery randomized controlled trial: the MARS feasibility study. J Thorac Oncol. 2009 Aug 5. [Epub ahead of print].

    Google Scholar 

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Authors and Affiliations

  1. Department of Thoracic Surgery, Glenfield Hospital, Leicester, UK

    David A. Waller

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  1. David A. Waller
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Editors and Affiliations

  1. Dept. Surgery, Mail Code 5035, University of Chicago, S. Maryland Avenue 5841, Chicago, 60637, Illinois, USA

    Mark K. Ferguson

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Waller, D.A. (2011). Malignant Pleural Mesothelioma: Patient Selection for Extrapleural Pneumonectomy. In: Ferguson, M. (eds) Difficult Decisions in Thoracic Surgery. Springer, London. https://doi.org/10.1007/978-1-84996-492-0_48

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  • DOI: https://doi.org/10.1007/978-1-84996-492-0_48

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  • Online ISBN: 978-1-84996-492-0

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