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Please use this identifier to cite or link to this item: http://hdl.handle.net/1959.14/301470
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- Title
- A Systematic review and meta-analysis of surgical treatments for malignant pleural mesothelioma
- Related
- Lung cancer, Vol. 83, No. 2, (2014), p.240-245
- DOI
- 10.1016/j.lungcan.2013.11.026
- Publisher
- Elsevier
- Date
- 2014
- Author/Creator
- Cao, Christopher
- Author/Creator
- Tian, David
- Author/Creator
- Park, John
- Author/Creator
- Allan, James
- Author/Creator
- Pataky, Kristopher A
- Author/Creator
- Yan, Tristan D
- Description
- Background: Malignant pleural mesothelioma (MPM) is an aggressive disease of the pleural lining with a dismal prognosis. Surgical treatments of MPM with a curative intent include extrapleural pneumonectomy and extended pleurectomy/decortication (P/D). This meta-analysis aimed to compare the perioperative and long-term outcomes of EPP and extended P/D for selected surgical candidates. Methods: A systematic review of the literature was performed on six electronic databases to identify all relevant data on comparative outcomes of extended P/D and EPP in a multimodality setting. Endpoints included perioperative mortality and morbidity, as well as long-term overall survival. Results: Seven relevant studies with comparative data on EPP (n=632) versus extended P/D (n=513) were identified from the current literature. Comparison of these two groups demonstrated significantly lower perioperative mortality (2.9% vs 6.8%, p=. 0.02) and morbidity (27.9% vs 62.0%, p<. 0.0001) for patients who underwent extended P/D compared to EPP. Median overall survival ranged between 13-29 months for extended P/D and 12-22 months for EPP, with a trend favouring extended P/D. Conclusions: Although it must be emphasized that patient selection and treatment strategies differ between EPP and extended P/D, a number of comparative studies have recently been conducted to compare these two surgical techniques for patients with resectable MPM. The present study indicated that selected patients who underwent extended P/D had lower perioperative morbidity and mortality with similar, if not superior, long-term survival compared to EPP, in the context of multi-modality therapy. This may represent an important paradigm shift in the surgical management of MPM.
- Description
- 6 page(s)
- Subject Keyword
- Mesothelioma
- Subject Keyword
- Meta-analysis
- Subject Keyword
- Pleurectomy
- Subject Keyword
- Pneumonectomy
- Subject Keyword
- Surgery
- Subject Keyword
- Systematic review
- Resource Type
- journal article
- Organisation
- Macquarie University. Australian School of Advanced Medicine
- Identifier
- http://hdl.handle.net/1959.14/301470
- Identifier
- mq:32748
- Identifier
- ISSN:0169-5002
- Identifier
- mq-rm-2013004521
- Identifier
- mq_res-ext-2-s2.0-84892848039
- Language
- eng
- Reviewed
Macquarie University ResearchOnline
