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Titolo:
Trimodality management of malignant pleural mesothelioma
Autore:
Maggi, G; Casadio, C; Cianci, R; Rena, O; Ruffini, E;
Indirizzi:
Univ Turin, San Giovanni Battista Hosp, Dept Thorac Surg, I-10126 Turin, Italy Univ Turin Turin Italy I-10126 p, Dept Thorac Surg, I-10126 Turin, Italy
Titolo Testata:
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
fascicolo: 3, volume: 19, anno: 2001,
pagine: 346 - 350
SICI:
1010-7940(200103)19:3<346:TMOMPM>2.0.ZU;2-S
Fonte:
ISI
Lingua:
ENG
Soggetto:
EXTRAPLEURAL PNEUMONECTOMY; DIFFUSE; THERAPY;
Keywords:
malignant pleural mesothelioma; pleural disease; extrapleural pneumonectomy; pleurectomy/decortication;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
16
Recensione:
Indirizzi per estratti:
Indirizzo: Maggi, G Univ Turin, San Giovanni Battista Hosp, Dept Thorac Surg, Via Genova 3, I-10126 Turin, Italy Univ Turin Via Genova 3 Turin Italy I-10126 I-10126 Turin, Italy
Citazione:
G. Maggi et al., "Trimodality management of malignant pleural mesothelioma", EUR J CAR-T, 19(3), 2001, pp. 346-350

Abstract

Objective: We reviewed our experience with trimodality management of malignant pleural mesothelioma (MPM). Methods: From September 1998 to August 2000, 32 consecutive patients with histological diagnosis of MPM underwent trimodality therapy, including surgery followed by adjuvant chemotherapy and radiation therapy. Surgery consisted of pleurectomy/decortication (P/D) or pleural-pericardial-pneumonectomy and diaphragm (PPPD). Pre-operative staging according to the Brigham Staging System was accomplished using computed tomography (CT) and magnetic resonance imaging (MRI); patients with evident extrapleural spread were excluded. Results. Our series included 21 men and 11 women with a median age of 53.5 years (range 40-69). Histologically, there were 26 epithelial, four mixed and two sarcomatous MPM. Post-surgical staging was as follows: six patients were at Stage I; of these, two received a P/D and four a PPPD. Ten patients were at Stage Il and all received a PPPD; 16 patients were at Stage m (under-staged pre-operatively): of these, nine patients presented extrapleural lymph node metastases (N2) and all received a PPPD, seven patients presented with chest wall or mediastinal invasion (T4) with macroscopic residual tumour, and ail received a de-bulking P/D. We observed major complications in ten patients: six bleeding, two respiratory insufficiency and two nerve paralysis. There were two perioperative deaths (6.25% mortality). Twenty-seven patients out of 30 surviving surgery had a follow-up greater than 6 months; 21 patients out of 27 are alive with a median follow-up of 12.5 months. Conclusions: (1) Trimodality therapy is feasible in selected patients with MPM and has an acceptable operative mortality rate. (2) Our current pre-operative staging based on CT/MRI looks rather inaccurate and needs to be improved. (3) The high rate of post-surgicalN2 patients or with diffusion to the inferior surface of the diaphragm maysuggest the use of routine mediastinoscopy and laparoscopy for a more appropriate patient selection. (C) 2001 Elsevier Science B.V. All rights reserved.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/11/20 alle ore 16:52:18