Survey of surgical treatment of malignant pleural mesothelioma in Japan
Friday, January 26th, 2007.
Kyobu Geka. 2007 Jan;60(1):19-24. [Link]
Higashiyama M, Morinaga K.
Department of Thoracic Surgery, Osaka Medical Center for Cancer and Cardiovascular Disease, Osaka, Japan.
Abstract
Surgical results of patients with malignant pleural mesothelioma (MPM) in Japan was surveyed from the results of a questionnaire sent to members of the Japan Lung Cancer Society and a total of 132 surgical cases of MPM from 1997 to 2002 were analyzed. They consisted of 112 males and 20 females. By histological type, 87 cases had epithelial type, 10 had sarcomatous type, 26 had mixed type and 2 had uncommon type of MPM (the histology of 7 cases was not indicated). As to the surgical mode, extrapleural pneumonectomy (EPP) was performed in 73 cases, and limited surgery such as decortication and tumorectomy was performed in 59 cases. The tumor was potentially completely resected in 83 cases. Postoperative adjuvant therapy was performed in 56 cases. The 1-, 2- and 3-year survival rates of the present cases were 54, 33 and 21%, respectively, and the perioperative mortality rate was 5%. These survival and mortality rates in the present series were almost similar to those of the MPM cases in the previously reported series from 1987 to 1996 by Takagi et al. According to Cox regression analysis, prognostic factors for survival included postoperative adjuvant therapy (p=0.003) and complete resection (p=0.037) significantly, and International Mesothelioma Interest Group (IMIG) stage (p=0.051) and performance status (p=0.086) with a marginal significance, indicating that complete surgical resection of the tumor and perioperative adjuvant therapy could be effective treatment for MPM in Japan. Thus, the development of multimodality therapy including surgical treatment for this disease may be required to improve surgical results of MPM patients.
Glossary
- adjuvant therapy
- (add-joo-vunt) treatment used in addition to the main treatment. It usually refers to hormonal therapy, chemotherapy, or radiation added after surgery to increase the chances of curing the disease or keeping it in check.
- therapy
- any of the measures taken to treat a disease. Unproven therapy is any therapy that has not been scientifically tested and approved. Use of an unproven therapy instead of standard (proven) therapy is called alternative therapy. Some alternative therapies have dangerous or even life-threatening side effects. For others, the main danger is that a patient may lose the opportunity to benefit from standard therapy. Complementary therapy, on the other hand, refers to therapies used in addition to standard therapy. Some complementary therapies may help relieve certain symptoms of cancer, relieve side effects of standard cancer therapy, or improve a patient's sense of well-being. The ACS recommends that patients considering use of any alternative or complementary therapy discuss this with their health care team.
- 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.
- cancer
- malignancy; a group of diseases typified by abnormal, generally out-of-control, cell growth.
- tumor
- an abnormal lump or mass of tissue. Tumors can be benign (not cancerous) or malignant (cancerous).
- mesothelioma
- a tumor derived from mesothelial tissue, such as the peritoneum (lining the abdomen) or pleura (lining the lungs). More on mesothelioma.
- multimodality therapy
- an approach to therapy which utilizes a variety of treatments at once as opposed to following only one mode of treatment.
- 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.
