Archive for the 'Extrapleural Pneumonectomy (EPP)' Category
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.
February 22nd, 2008. Epidemiology, molecular biology, diagnostic and therapeutic strategy of malignant pleural mesothelioma in 2007 – an update
Antiangiogenic agents such as bevacizumab (Avastatin) may be of interest but need to be tested in phase 3 trials. The Mesothelioma Avastatin Pemetrexed Study (MAPS) is ongoing, coordinated by the French Thoracic Cancer Intergroup (IFCT).
Posted in Angiogenesis, Bevacizumab (Avastatin), Causation, Chemotherapy, CT or CAT scan, Diagnosis & Differentiation, Epidemiological, Extrapleural Pneumonectomy (EPP), Full Archive, General, Immunohistochemistry or IHC, Pemetrexed (Alimta), PET Scan, Pleural, Surgery, thoracoscopy, Treatment, Type of Assessment:, Type of Mesothelioma: | No Comments »
February 11th, 2008. Intensity-Modulated Radiotherapy for Resected Mesothelioma: The Duke Experience
Conclusions: With limited follow-up, 45-Gy IMRT provides reasonable local control for mesothelioma after extrapleural pneumonectomy. However, treatment-related pulmonary toxicity remains a significant concern. Care should be taken to minimize the dose to the remaining lung to achieve an acceptable therapeutic ratio.
January 22nd, 2008. Evaluating target coverage and normal tissue sparing in the adjuvant radiotherapy of malignant pleural mesothelioma: Helical tomotherapy compared with step-and-shoot IMRT
Conclusions: Our planning study showed that helical tomotherapy is an excellent option for the adjuvant intensity-modulated radiotherapy of MPM. It is capable of improving target coverage and homogeneity.
Posted in Chemotherapy, Cisplatin (Platinol ®), Determining Efficacy, Extrapleural Pneumonectomy (EPP), Full Archive, IMRT, Pemetrexed (Alimta), Pleural, Radiation, Surgery, Treatment, Type of Assessment:, Type of Mesothelioma: | No Comments »
January 16th, 2008. Anesthetic management of patients undergoing extrapleural pneumonectomy for mesothelioma
This review summarizes relevant surgical aspects and anesthetic insights from the Brigham and Women's Hospital experience. Included are the anesthetic implications of intraoperative intracavitary hyperthermic chemotherapy in combination with extrapleural pneumonectomy - an emerging therapeutic option in the treatment of malignant pleural mesothelioma.
Posted in Chemotherapy, Determining Efficacy, Extrapleural Pneumonectomy (EPP), Full Archive, Intrapleural Chemotherapy, Pleural, Pleurectomy/decortication, Surgery, Treatment, Type of Assessment:, Type of Mesothelioma: | No Comments »
January 2nd, 2008. Malignant pleural mesothelioma: interrogations and hopes concerning the expected epidemic
In 2007, a more aggressive therapeutic approach is becoming common practice with the use of radiotherapy and the emergence of the concept of multimodal care centered on wide pleuropneumonectomy. These advances create real hope for improvement, but also many interrogations since no standard treatment protocol has been clearly identified.
Posted in Epidemiological, Extrapleural Pneumonectomy (EPP), Full Archive, General, Pleural, Pneumonectomy, Surgery, Treatment, Trimodality Therapy, Type of Assessment:, Type of Mesothelioma: | No Comments »
January 1st, 2008. Malignant pleural mesothelioma: clinicopathologic and survival characteristics in a consecutive series of 394 patients
Conclusions: Significant predictors of survival include performance status, platelet count, histology, and degree of involvement of pleural cavity. Within the confines of this retrospective study and the small number of patients undergoing multimodality therapy, the role of surgery in the treatment of MPM remains unclear. Further investigation is warranted to determine the optimal treatment strategy in this disease.
December 25th, 2007. Malignant pleural mesothelioma: surgical management in 285 patients
Conclusions: Extrapleural pneumonectomy can be performed with similar 30-day mortality as other procedures for malignant pleural mesothelioma with a median survival better than subtotal pleurectomy, exploration without resection, and biopsy alone. However, extrapleural pneumonectomy has significant morbidity and a 3-year survival of only 14%.
December 8th, 2007. Endoscopic ultrasound-guided fine needle aspiration is useful for nodal staging in patients with pleural mesothelioma
EUS-FNA is a safe N2 node staging technique in patients with mesothelioma. A positive N2 lymph node by EUS-FNA may be a contraindication to definitive surgery in patients with malignant mesothelioma.
December 7th, 2007. Renal cell carcinoma with malignant pleural mesothelioma after asbestos exposure: a case report
The incidence is rising in industrialized countries, with the peak expected in the year 2020. However, renal cell carcinoma with malignant pleural mesothelioma is very rare and this is the 2nd case in the Japanese literature.
Posted in Case Study, Causation, Chemotherapy, CT or CAT scan, Diagnosis & Differentiation, Epidemiological, Extrapleural Pneumonectomy (EPP), Full Archive, Occupational Asbestos Exposure, Pleural, Pleural Effusion, Radiation, Surgery, Symptoms & Symptom Management, Treatment, Trimodality Therapy, Type of Assessment:, Type of Mesothelioma: | No Comments »
December 1st, 2007. Radical surgery for malignant pleural mesothelioma: results and prognosis
0019), but not gender, side, surgical procedure, were significant independent negative prognostic factors. Although P/D appears to be acceptable in early stages, we encourage EPP, en bloc resection without entering the pleural cavity with intent for curability, which provides oncologically complete resection of all disease.
October 31st, 2007. Real surgical morbidity and mortality after extrapleural pneumonectomy
3%). If the results of this novel study of long-term surgical outcomes of extrapleural pneumonectomy were to be confirmed, the preoperative risk/benefit balance of the procedure, mainly when performed for thoracic malignancies, should therefore include the entire spectrum of (early and late) potential surgery-related complications.
October 24th, 2007. Outcomes After Extrapleural Pneumonectomy and Intensity-Modulated Radiation Therapy for Malignant Pleural Mesothelioma
Conclusions: Intensity-modulated radiation therapy after EPP results in excellent local control for malignant pleural mesothelioma; however, distant metastases remain a significant problem and limit survival. This provides a strong rationale for combining aggressive local regimens with systemic therapy.
October 13th, 2007. Combined photon and electron three-dimensional conformal versus intensity-modulated radiotherapy with integrated boost for adjuvant treatment of malignant pleural mesothelioma after pleuropneumonectomy
Conclusion: Intensity-modulated RT and 3D-CRT are both suitable for adjuvant RT. IMRT improves the planning target volume coverage but delivered greater doses to the organs at risk. Rigid dose constraints for the lung should be respected.
October 9th, 2007. Gene methylation in pleural mesothelioma: Correlations with clinico-pathological features and patient’s follow-up
In the overall population, methylation did not correlate to patient outcome but a trend to an improved survival was detectable in ummethylated MPM treated with extrapleural pneumonectomy. This result suggests the need to select homogeneously treated and staged patients with MPM to address whether their methylation profile may impact on patient's survival.
October 3rd, 2007. Prognostic factors in the treatment of malignant pleural mesothelioma at a large tertiary referral center
Conclusions: In addition to tumor histology and pathologic stage, predictors of survival include gender, asbestos exposure, smoking, symptoms, laterality, and clinical stage. Surgical resection in a multimodality setting was associated with improved survival.
Posted in CT or CAT scan, Determining Efficacy, Diagnosis & Differentiation, Extrapleural Pneumonectomy (EPP), Full Archive, General, Pleural, Pleurectomy/decortication, Staging, Surgery, Survival, Treatment, Trimodality Therapy, Type of Assessment:, Type of Mesothelioma: | No Comments »
September 26th, 2007. Restricted Field IMRT Dramatically Enhances IMRT Planning for Mesothelioma
Conclusion: Restricted field IMRT provides an improved method to deliver IMRT to a complex target after extrapleural pneumonectomy. An upcoming Phase I trial will provide validation of these results.
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