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VATS Pleurectomy Decortication Is a Reasonable Alternative for Higher Risk Patients in the Management of Malignant Pleural Mesothelioma: An Analysis of Short-Term Outcomes

SIMPLE SUMMARY: Malignant pleural mesothelioma (MPM) is an aggressive malignancy that drastically affects a patient’s quality of life. Surgery typically entails radical resection with or without the removal of the underlying lung. In an era where minimally invasive surgery is sought after, MPM remai...

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Autores principales: Lee, Dong-Seok, Carollo, Andrea, Alpert, Naomi, Taioli, Emanuela, Flores, Raja
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7959123/
https://www.ncbi.nlm.nih.gov/pubmed/33802319
http://dx.doi.org/10.3390/cancers13051068
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author Lee, Dong-Seok
Carollo, Andrea
Alpert, Naomi
Taioli, Emanuela
Flores, Raja
author_facet Lee, Dong-Seok
Carollo, Andrea
Alpert, Naomi
Taioli, Emanuela
Flores, Raja
author_sort Lee, Dong-Seok
collection PubMed
description SIMPLE SUMMARY: Malignant pleural mesothelioma (MPM) is an aggressive malignancy that drastically affects a patient’s quality of life. Surgery typically entails radical resection with or without the removal of the underlying lung. In an era where minimally invasive surgery is sought after, MPM remains an anomaly. The purpose of this study is to assess the feasibility of minimally invasive surgery as an alternative to more radical surgery in MPM. We examined short-term outcomes between the radical approaches and minimally invasive surgery and minimally invasive surgery had improved outcomes. Minimally invasive surgery can be considered in patients with MPM. ABSTRACT: Surgery is a mainstay of treatment allowing for debulking of tumor and expansion of the lung for improvement in median survival and quality of life for patients with malignant pleural mesothelioma (MPM). Although optimal surgical technique remains open for debate—extrapleural pneumonectomy (EPP) vs. pleurectomy/decortication (P/D)—minimally invasive surgery (VATS-P/D) remains underutilized in the management of MPM. We examined whether VATS-P/D is a feasible alternative to EPP and P/D. We evaluated the New York Statewide Planning and Research Cooperative System (SPARCS) from 2007–2017 to assess the short-term complications of EPP vs. P/D, including a subanalysis of open P/D vs. VATS-P/D. There were 331 patients with open surgery; 269 with P/D and 62 with EPP. There were 384 patients with P/D; 269 were open and 115 VATS. Rates of any complication were similar between EPP and P/D patients, but EPP had significantly higher rates of cardiovascular complications. After adjusting for confounders, those with a VATS approach were less likely to have any complication, compared to an open approach and significantly less likely to have a pulmonary complication. VATS-P/D remains a viable alternative to radical surgery in MPM patients allowing for improved short-term outcomes.
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spelling pubmed-79591232021-03-16 VATS Pleurectomy Decortication Is a Reasonable Alternative for Higher Risk Patients in the Management of Malignant Pleural Mesothelioma: An Analysis of Short-Term Outcomes Lee, Dong-Seok Carollo, Andrea Alpert, Naomi Taioli, Emanuela Flores, Raja Cancers (Basel) Article SIMPLE SUMMARY: Malignant pleural mesothelioma (MPM) is an aggressive malignancy that drastically affects a patient’s quality of life. Surgery typically entails radical resection with or without the removal of the underlying lung. In an era where minimally invasive surgery is sought after, MPM remains an anomaly. The purpose of this study is to assess the feasibility of minimally invasive surgery as an alternative to more radical surgery in MPM. We examined short-term outcomes between the radical approaches and minimally invasive surgery and minimally invasive surgery had improved outcomes. Minimally invasive surgery can be considered in patients with MPM. ABSTRACT: Surgery is a mainstay of treatment allowing for debulking of tumor and expansion of the lung for improvement in median survival and quality of life for patients with malignant pleural mesothelioma (MPM). Although optimal surgical technique remains open for debate—extrapleural pneumonectomy (EPP) vs. pleurectomy/decortication (P/D)—minimally invasive surgery (VATS-P/D) remains underutilized in the management of MPM. We examined whether VATS-P/D is a feasible alternative to EPP and P/D. We evaluated the New York Statewide Planning and Research Cooperative System (SPARCS) from 2007–2017 to assess the short-term complications of EPP vs. P/D, including a subanalysis of open P/D vs. VATS-P/D. There were 331 patients with open surgery; 269 with P/D and 62 with EPP. There were 384 patients with P/D; 269 were open and 115 VATS. Rates of any complication were similar between EPP and P/D patients, but EPP had significantly higher rates of cardiovascular complications. After adjusting for confounders, those with a VATS approach were less likely to have any complication, compared to an open approach and significantly less likely to have a pulmonary complication. VATS-P/D remains a viable alternative to radical surgery in MPM patients allowing for improved short-term outcomes. MDPI 2021-03-03 /pmc/articles/PMC7959123/ /pubmed/33802319 http://dx.doi.org/10.3390/cancers13051068 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lee, Dong-Seok
Carollo, Andrea
Alpert, Naomi
Taioli, Emanuela
Flores, Raja
VATS Pleurectomy Decortication Is a Reasonable Alternative for Higher Risk Patients in the Management of Malignant Pleural Mesothelioma: An Analysis of Short-Term Outcomes
title VATS Pleurectomy Decortication Is a Reasonable Alternative for Higher Risk Patients in the Management of Malignant Pleural Mesothelioma: An Analysis of Short-Term Outcomes
title_full VATS Pleurectomy Decortication Is a Reasonable Alternative for Higher Risk Patients in the Management of Malignant Pleural Mesothelioma: An Analysis of Short-Term Outcomes
title_fullStr VATS Pleurectomy Decortication Is a Reasonable Alternative for Higher Risk Patients in the Management of Malignant Pleural Mesothelioma: An Analysis of Short-Term Outcomes
title_full_unstemmed VATS Pleurectomy Decortication Is a Reasonable Alternative for Higher Risk Patients in the Management of Malignant Pleural Mesothelioma: An Analysis of Short-Term Outcomes
title_short VATS Pleurectomy Decortication Is a Reasonable Alternative for Higher Risk Patients in the Management of Malignant Pleural Mesothelioma: An Analysis of Short-Term Outcomes
title_sort vats pleurectomy decortication is a reasonable alternative for higher risk patients in the management of malignant pleural mesothelioma: an analysis of short-term outcomes
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7959123/
https://www.ncbi.nlm.nih.gov/pubmed/33802319
http://dx.doi.org/10.3390/cancers13051068
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