Important prognostic factors in patients with malignant pleural mesothelioma, managed surgically Journal Article


Authors: Rusch, V. W.; Venkatraman, E. S.
Article Title: Important prognostic factors in patients with malignant pleural mesothelioma, managed surgically
Abstract: Background. The factors influencing outcome after resection of malignant pleural mesothelioma (MPM) are controversial. This analysis of a prospective surgical database identifies important prognostic factors. Methods. Tumors were staged by the International Mesothelioma Interest Group staging system, and patients were followed until death. Prognostic factors were analyzed by log rank and Cox regression, and were considered significant if p was less than 0.05. Results. From Oct 1983 to May 1998, 231 patients underwent thoracotomy, 115 had extrapleural pneumonectomy (EPP), and 59 pleurectomy/decortication (P/D). Among patients having EPP or P/D, 142 received adjuvant therapy. The median survival for stage I tumors was 29.9 months, for stage II 19 months, for stage III 10.4 months, and for stage IV 8 months. By multivariate analysis, stage, histology, gender, adjuvant therapy, but not the type of surgical resection, were significant. Conclusions. The better survival previously reported for P/D compared with EPP is not seen in a large database with long follow-up. Stages I and II have better survival rates than generally assumed for MPM. Locally advanced T and N status, and nonepithelial histology, identify poor prognosis patients who should be considered for novel treatment regimens.
Keywords: adult; cancer survival; human tissue; aged; aged, 80 and over; middle aged; cancer surgery; survival rate; major clinical study; cancer adjuvant therapy; cancer staging; lymphatic metastasis; neoplasm staging; prospective studies; pneumonectomy; survival time; malignant mesothelioma; pleura mesothelioma; mesothelioma; pleura; pleural neoplasms; humans; prognosis; human; male; female; priority journal; article
Journal Title: Annals of Thoracic Surgery
Volume: 68
Issue: 5
ISSN: 0003-4975
Publisher: Elsevier Science, Inc.  
Date Published: 1999-11-01
Start Page: 1799
End Page: 1804
Language: English
DOI: 10.1016/s0003-4975(99)01038-3
PUBMED: 10585061
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 16 August 2016 -- Source: Scopus
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  1. Venkatraman Ennapadam Seshan
    382 Seshan
  2. Valerie W Rusch
    865 Rusch