Surgical staging and treatment in malignant pleural mesothelioma
Friday, September 15th, 2006.
Revista Portuguesa de Pneumologia. 2005 Nov;11(6 Suppl 1):18. [Link]
Matilla J, Felix F, Polo M, Rodrigues C, Moreira E, Godinho T.
Servico de Cirurgia Toracica. Hospital Pulido Valente SA.
Abstract
Malignant peural mesothelioma is still one of the greatest therapeutic challenges for Pneumologists and Thoracic Surgeons. Latest results show gerat improvements in the fight against this terrible desease.
Objectives: surgical approach analyses, including staging methods, in malignant pleural mesothelioma.
Material and methods: 10 cases were analysed, 7 male and 3 female, with a median age of 63,2 years, which were operated betwen January 2000 and August 2005 diagnosed of epithelial mesothelioma. Surgical staging was perfomed by mediastinoscopy and thoracoscopy. Surgical resection was achieved in 8 patients : pleuropneumonectomy in 2 first patients and extrapleural pneumonectomy with reconstruction of hemi-diaphragm and pericardium in 6 cases; in the other 2 cases exploratory thoracotomy was permormed.
Results: In this series two complications were reported: one diaphragmatic hernia and one postpneumonectomy empyema which were solved with re operation; one single case of peri-operative mortality was reported. 5-Years survival data will be available soon. Videos of every procedure will be shown.
Glossary
- staging
- the process of finding out whether cancer has spread and if so, how far. There is more than one system for staging. The TNM system, described below, is one used often. The TNM system for staging gives three key pieces of information: T refers to the size of the Tumor N describes how far the cancer has spread to nearby Nodes M shows whether the cancer has spread (Metastasized) to other organs of the body Letters or numbers after the T, N, and M give more details about each of these factors. To make this information somewhat clearer, the TNM descriptions can be grouped together into a simpler set of stages, labeled with Roman numerals. In general, the lower the number, the less the cancer has spread. A higher number means a more serious cancer.
- resection
- surgery to remove part or all of an organ or other structure.
- mortality
- a measure of the rate of death from a disease within a given population.
- mediastinoscopy
- (me-dee-as-tin-OS-ko-pee) examination of the chest cavity using a lighted tube replaced under the chest bone (sternum). This allows the doctor to see the lymph nodes in this area and remove samples to check for cancer.
- mesothelioma
- a tumor derived from mesothelial tissue, such as the peritoneum (lining the abdomen) or pleura (lining the lungs). More on mesothelioma.
- extrapleural pneumonectomy
- (EPP) surgery to remove the pleura, diaphragm, pericardium, and entire lung involved with the tumor. You can view a web cast from Brigham and Women's Hospital in Boston of this procedure being done by Dr. David Sugarbaker: see the extrapleural pneumonectomy (EPP) web cast here.
