Archive for the 'Extrapleural Pneumonectomy (EPP)' Category
December 20th, 2008. Vitamin D-mediated hypercalcemia and Cushing syndrome as manifestations of malignant pleural mesothelioma
Conclusion: These findings support the evidence for a paracrine role of vitamin D in the resistance of the human host to antigen.
November 21st, 2008. Compensator-based intensity-modulated radiation therapy for malignant pleural mesothelioma post extrapleural pneumonectomy
Not all linear accelerators can deliver large-field MLC-based IMRT, but most can deliver a maximum conformal field of 40 x 40 cm. It is possible and reasonable to deliver IMRT with compensators for fields this size with most conventional linear accelerators.
October 16th, 2008. Histologic assessment and prognostic factors of malignant pleural mesothelioma treated with extrapleural pneumonectomy
Postoperative treatment was associated with DSS and with recurrence-free survival. Our study confirms that in many cases, final histopathologic typing of MPM is influenced by complete surgical resection and that initial biopsy should be carefully weighed in the treatment stratification.
September 23rd, 2008. 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
Conclusion: This study confirms a preferential pattern of drainage of malignant pleural mesothelioma to N2 rather than N1 lymph nodes, but suggests that N1 only nodal involvement should be classified as lower stage disease. Multiple N2 nodal site involvement could potentially be classified as higher stage disease than single station N2. Our results emphasize the need for larger, confirmatory multicenter studies that could lead to revision of the current staging system.
Posted in Diagnosis & Differentiation, Extrapleural Pneumonectomy (EPP), Full Archive, Pleural, Pleurectomy/decortication, Staging, Surgery, Survival, Treatment, Type of Assessment:, Type of Mesothelioma: | No Comments »
September 19th, 2008. Preoperative staging of mesothelioma by 18F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography fused imaging and mediastinoscopy compared to pathological findings after extrapleural pneumonectomy
Conclusions: Non-curative surgery is avoided in 29% out of 42 MPM patients by preoperative PET/CT and in further 14% by mediastinoscopy. Even though both procedures are valuable, there are false negative findings with both, urging for even more accurate staging procedures.
September 2nd, 2008. Recent advances in the treatment of malignant pleural mesothelioma
Vorinostat, a small molecule inhibitor of HDAC, which targets select members of class I and II HDACs, has shown early evidence of activity and is currently being evaluated in a randomized study for patients who progress with standard therapy for advanced mesothelioma. It is hoped that the HDAC inhibitors and other novel targeted agents will pave the way for improved outcomes for patients with this disease.
Posted in Chemotherapy, Cisplatin (Platinol ®), Determining Efficacy, Extrapleural Pneumonectomy (EPP), Full Archive, Gene Therapy, Pemetrexed (Alimta), Pleural, Pleurectomy/decortication, Radiation, Surgery, Treatment, Type of Assessment:, Type of Mesothelioma: | No Comments »
September 2nd, 2008. Diagnosis, Staging, and Surgical Treatment of Malignant Pleural Mesothelioma
The primary goal of surgery in this setting is the resection of all gross disease. The choice of operation, extrapleural pneumonectomy (EPP) or pleurectomy/decortication (P/D), depends on disease stage, pulmonary function, philosophy of the treating physician, and type of planned adjuvant therapy.
Posted in Chemotherapy, Determining Efficacy, Diagnosis & Differentiation, Extrapleural Pneumonectomy (EPP), Full Archive, Pleural, Pleurectomy/decortication, Staging, Surgery, Treatment, Trimodality Therapy, Tumor Debulking, Type of Assessment:, Type of Mesothelioma: | No Comments »
July 11th, 2008. Incidence of atrial fibrillation after extrapleural pneumonectomy versus pleurectomy in patients with malignant pleural mesothelioma
The increased odds of having AF after EPP could be due to right heart stress caused by pneumonectomy. Increased right heart stress might not be sufficient to cause AF alone, but may be an important risk factor that warrants further investigation.
Posted in Determining Efficacy, Extrapleural Pneumonectomy (EPP), Full Archive, Pleural, Pleurectomy/decortication, Pneumonectomy, Surgery, Survival, Treatment, Type of Assessment:, Type of Mesothelioma: | No Comments »
July 9th, 2008. Malignant mesothelioma: current status and perspective in Japan and the world
In this context, combination therapy with surgery plus chemotherapy and/or radiotherapy is currently considered the standard treatment for patients with respectable MPM. A national survey of EPP was conducted recently in Japan, and a few multicenter clinical trials will start soon.
Posted in Chemotherapy, Diagnosis & Differentiation, Extrapleural Pneumonectomy (EPP), Full Archive, Pleural, Pleurectomy/decortication, Radiation, Staging, Surgery, Treatment, Trimodality Therapy, Type of Assessment:, Type of Mesothelioma:, thoracoscopy | No Comments »
July 1st, 2008. Morbidity, mortality, mean survival, and the impact of histology on survival after pleurectomy in 64 patients with malignant pleural mesothelioma
Conclusion: Our results show that pleurectomy can be performed as a means of palliation for advanced-stage disease with a low mortality rate and may, in fact, improve survival in patients with epithelial subtype as compared with historical controls in the literature with no surgical intervention.
Posted in Biphasic or Mixed, Determining Efficacy, Epithelioid, Extrapleural Pneumonectomy (EPP), Full Archive, Pleural, Sarcomatoid, Surgery, Survival, Treatment, Type of Assessment:, Type of Mesothelioma: | No Comments »
June 24th, 2008. Multimodal Therapy for Malignant Pleural Mesothelioma Including Extrapleural Pneumonectomy
During the follow-up duration of 23 months, 3 patients (18 %) developed distant metastasis and one (6 %) a mediastinal local recurrence. Multimodal therapy of malignant pleural mesothelioma including extrapleural pneumonectomy should only be performed in specialised centres for thoracic surgery where uncomplicated interdisciplinary communication is the rule and which provide the required expertise in patient selection, operative technique and postoperative care.
Posted in Chemotherapy, Cisplatin (Platinol ®), Determining Efficacy, Extrapleural Pneumonectomy (EPP), Full Archive, Pemetrexed (Alimta), Radiation, Surgery, Survival, Treatment, Trimodality Therapy, Type of Assessment: | No Comments »
May 2nd, 2008. Trimodality Treatment of Malignant Pleural Mesothelioma
Conclusions: Trimodality treatment in malignant pleural mesothelioma seems to prolong survival in patients without lymph node metastasis. Novel techniques are needed for preoperative assessment of extrapleural lymph nodes.
Posted in Determining Efficacy, Epithelioid, Extrapleural Pneumonectomy (EPP), Full Archive, Sarcomatoid, Surgery, Survival, Treatment, Trimodality Therapy, Type of Assessment:, Type of Mesothelioma: | No Comments »
April 30th, 2008. The value of occult disease in resection margin and lymph node after extrapleural pneumonectomy for malignant mesothelioma
Conclusions: In malignant pleural mesothelioma, the presence of occult disease in resection margins and lymph nodes can be identified by immunohistochemistry and significantly influences the prognosis. Cervical mediastinoscopy is useful in all patients considered for radical resection, but all specimens should be processed with immunohistochemical staining.
Posted in Biphasic or Mixed, Determining Efficacy, Diagnosis & Differentiation, Epithelioid, Extrapleural Pneumonectomy (EPP), Full Archive, Immunohistochemistry or IHC, Pleural, Sarcomatoid, Staging, Surgery, Survival, Treatment, Type of Assessment:, Type of Mesothelioma: | No Comments »
April 15th, 2008. Outcome after extrapleural pneumonectomy for malignant pleural mesothelioma
Conclusion: Extrapleural pneumonectomy as part of a multi-modality treatment regimen is a good treatment option for selected patients with malignant pleural mesothelioma. The long-term results of this limited series compare favourably to non-surgical treatment regimens. Larger randomised prospective multi-centre trials are warranted to establish clear guidelines.
April 10th, 2008. Surgical Treatment in the Management of Malignant Pleural Mesothelioma: A Single Institution’s Experience
Conclusions: In highly selected patients local control can be achieved with combination therapy but is accompanied by a high rate of (surgical) complications. Distant failure rates warrant further studies exploring the role of systemic chemotherapy while the use of cytoreductive surgery with intraoperative chemoperfusion for MPM is not supported.
Posted in Determining Efficacy, Extrapleural Pneumonectomy (EPP), Full Archive, Intrapleural Chemotherapy, Pleural, Pleurectomy/decortication, Radiation, Surgery, Survival, Treatment, Type of Assessment:, Type of Mesothelioma: | No Comments »
April 3rd, 2008. The role of muscle flap in preventing bronchus stump insufficiency after pneumonectomy for malignant pleural mesothelioma in high-risk patients
There was no early or late stump insufficiency during the 15-month follow-up. Surgical techniques using muscle flap seems to play a major role in the prevention of bronchus stump insufficiency especially after neo-adjuvant chemotherapy.
Posted in Chemotherapy, Cisplatin (Platinol ®), Extrapleural Pneumonectomy (EPP), Full Archive, Gemcitabine (Gemzar), Pleural, Pneumonectomy, Radiation, Surgery, Symptoms & Symptom Management, Treatment, Type of Assessment:, Type of Mesothelioma: | No Comments »
April 1st, 2008. Impact of tumor-infiltrating T cells on survival in patients with malignant pleural mesothelioma
Conclusion: The presence of high levels of CD8+ tumor-infiltrating lymphocytes is associated with better prognosis in patients undergoing extrapleural pneumonectomy for malignant pleural mesothelioma. The stimulation of CD8+ lymphocytes can be a potential therapeutic strategy to improve outcome.
Posted in Diagnosis & Differentiation, Extrapleural Pneumonectomy (EPP), Full Archive, Immune-based Therapies, Immunohistochemistry or IHC, Pleural, Surgery, Survival, Treatment, Type of Assessment:, Type of Mesothelioma: | No Comments »
March 22nd, 2008. Risk Factors for Major Complications After Extrapleural Pneumonectomy for Malignant Pleural Mesothelioma
Conclusions: Right EPP and more than 4 units of RBC transfusion are associated with increased risk of major complications. Although patients undergoing induction chemotherapy received more RBC transfusions, induction chemotherapy did not directly impact the risk of major complications.
March 15th, 2008. Evaluation of the rehabilitation program in a patient submitted to pleuropneumonectomy for malignant pleural mesothelioma
Conclusions: Future studies will define the role of the rehabilitation for MPM patients and will optimize the protocol.
March 11th, 2008. Extrapleural pneumonectomy versus pleurectomy/decortication in the surgical management of malignant pleural mesothelioma: Results in 663 patients
Conclusion: Patients who underwent pleurectomy/decortication had a better survival than those who underwent extrapleural pneumonectomy; however, the reasons are multifactorial and subject to selection bias. At present, the choice of resection should be tailored to the extent of disease, patient comorbidities, and type of multimodality therapy planned.
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