Archive for the 'Pleurectomy/decortication' Category
November 26th, 2008. Mesothelioma: treatment
There are few active cytotoxic drugs in this disease. Currently, based on two randomised trials, the most efficacious chemotherapy regimen consists in a combination of cisplatin and an antifolate agent, pemetrexed or raltitrexed.
Posted in Chemotherapy, Cisplatin (Platinol ®), Full Archive, Pemetrexed (Alimta), Pleural, Pleurectomy/decortication, Pneumonectomy, Radiation, Raltitrexed (Tomudex), Surgery, Treatment, Type of Assessment:, Type of Mesothelioma: | No Comments »
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 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 29th, 2008. Open lung-sparing surgery for malignant pleural mesothelioma: the benefits of a radical approach within multimodality therapy
Conclusion: If a patient with epithelioid MPM is fit enough to tolerate a thoracotomy then macroscopic clearance of the tumour is the preferred option as part of a multimodality regime including chemotherapy.
Posted in Chemotherapy, Epithelioid, Full Archive, Pleurectomy/decortication, Radiation, Surgery, Survival, Treatment, Trimodality Therapy, 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 »
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 »
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 27th, 2008. Review: intracavitary radioimmunotherapy to treat solid tumors
RIT may have potential for palliation in patients with malignant pleural mesothelioma or malignant pleural effusion. The future of RIT may, therefore, not only be in the inclusion in contemporary multimodality treatment, but also in the expansion to palliative treatment.
January 31st, 2008. Environmental cancer: malignant pleural mesothelioma
Active and multidisciplinary therapeutic strategies are currently evaluated and the concept of multimodality treatment includes new effective chemotherapies improving survival and quality of life, modern modalities of radiotherapy and pleuropneumonectomy. This advances create hopes and interrogations because it is not currently know whether multimodality treatment will be the standard in MPM.
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 »
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 25th, 2007. Localised malignant pleural mesothelioma: a separate clinical entity requiring aggressive local surgery
Conclusion: Our results suggest that surgery is indicated in treating localised MPM even in T4 (diffuse chest wall involvement) tumours but pleuropneumonectomy is not necessary. These tumours seem to have a different biological behaviour compared to diffuse MPM but further research, including identification of possibly different biological markers is necessary.
Posted in Biphasic or Mixed, Epithelioid, Full Archive, Pleural, Pleurectomy/decortication, Pneumonectomy, Sarcomatoid, Surgery, Survival, Treatment, Tumor Debulking, 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 3rd, 2007. Mesothelioma of the pleura in the Province of Trieste
Conclusions: In the Province of Trieste the mesothelioma epidemic does not show any signs of abatement. Besides marine work, a variety of other occupations appear to be associated with the tumour in this area.
Posted in Causation, Diagnosis & Differentiation, Epidemiological, Full Archive, Occupational Asbestos Exposure, Pleural, Pleurectomy/decortication, Pneumonectomy, Surgery, Type of Assessment:, Type of Mesothelioma:, thoracoscopy | No Comments »
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 »
August 3rd, 2007. Malignant pleural mesothelioma: outcome of limited surgical management
03). Survival after limited surgical management of malignant mesothelioma is comparable to a previously reported more radical surgical approach.
April 6th, 2007. Four-Modality Therapy in Malignant Pleural Mesothelioma: A Phase II Study
Conclusion: The four-modality treatment that we adopted for advanced-stage MPM was feasible, well tolerated by most of the patients, and produced a favorable median survival. This treatment approach warrants further investigation.
Posted in Chemotherapy, Cisplatin (Platinol ®), Determining Efficacy, Full Archive, Gemcitabine (Gemzar), Pleural, Pleurectomy/decortication, Radiation, Surgery, Treatment, Trimodality Therapy, Type of Assessment:, Type of Mesothelioma: | No Comments »
March 6th, 2007. Case-control study between extrapleural pneumonectomy and radical pleurectomy/decortication for pathological N2 malignant pleural mesothelioma
Conclusions: Preservation of the lung during radical surgery for N2 MM does not compromise survival even in an older group population. We therefore now have ceased to perform EPP in cases of N2 disease and we make every effort to accurately stage patients with mediastinoscopy to identify them.
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