JTCS Email Content Delivery
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Valerie W. Rusch
Manjit S. Bains
Robert J. Ginsberg
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Rusch, V. W.
Right arrow Articles by Ginsberg, R. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Rusch, V. W.
Right arrow Articles by Ginsberg, R. J.
Related Collections
Right arrow Pleura

J Thorac Cardiovasc Surg 2001;122:788-795
© 2001 The American Association for Thoracic Surgery

General Thoracic Surgery

A phase II trial of surgical resection and adjuvant high-dose hemithoracic radiation for malignant pleural mesothelioma

Valerie W. Rusch, MDa, Kenneth Rosenzweig, MDb, Ennapadam Venkatraman, PhDc, Larry Leon, MSc, Adam Raben, MDb, Louis Harrison, MDb, Manjit S. Bains, MDa, Robert J. Downey, MDa, Robert J. Ginsberg, MDa

From the Thoracic Service, Department of Surgery,a the Department of Radiation Oncology,b and the Biostatistics Service, Department of Epidemiology and Biostatistics,c Memorial Sloan-Kettering Cancer Center, New York, NY.

Presented in part at the 2000 Meeting of the American Society of Clinical Oncology.

Received for publication Feb 1, 2001. Revisions requested March 22, 2001; revisions received April 18, 2001. Accepted for publication April 19, 2001. Address for reprints: Valerie W. Rusch, MD, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10021 (E-mail: ruschv{at}mskcc.org).

Background: Surgical resection of malignant pleural mesothelioma is reported to have up to an 80% rate of local recurrence. We performed a phase II trial of high-dose hemithoracic radiation after complete resection to determine feasibility and to estimate rates of local recurrence and survival.
Methods: Patients were eligible if they had a resectable tumor, as determined by computed tomographic scanning, and adequate cardiopulmonary function for extrapleural pneumonectomy or pleurectomy/decortication. After complete resection, patients received hemithoracic radiation (54 Gy) and then were followed up with serial computed tomographic scanning.
Results: From 1995 to 1998, 88 patients (73 men and 15 women; median age, 62.5 years) were entered into the study. The operations performed included 62 extrapleural pneumonectomies (70%) and 5 pleurectomies/decortications; procedures for exploration only were performed in 21 patients. Seven (7.9%) patients died postoperatively. Adjuvant radiation administered to 57 patients (54 undergoing extrapleural pneumonectomy and 3 undergoing pleurectomy/decortication) at a median dose of 54 Gy was well tolerated (grade 0-2 fatigue, esophagitis), except for one late esophageal fistula. The median survival was 33.8 months for stage I and II tumors but only 10 months for stage III and IV tumors (P = .04). For the patients undergoing extrapleural pneumonectomy, the sites of recurrence were locoregional in 2, locoregional and distant in 5, and distant only in 30.
Conclusion: Hemithoracic radiation after complete surgical resection at a dose not previously reported is feasible. This approach dramatically reduces local recurrence and is associated with prolonged survival for early-stage tumors. Stage III disease has a high risk of early distant relapse and should be considered for trials of systemic therapy added to this regimen of resection and radiation.




This article has been cited by other articles:


Home page
 Ann. Thorac. Surg.Home page
G. Buduhan, S. Menon, R. Aye, B. Louie, V. Mehta, and E. Vallieres
Trimodality therapy for malignant pleural mesothelioma.
Ann. Thorac. Surg., September 1, 2009; 88(3): 870 - 875.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
T. D. Yan, M. Boyer, M. M. Tin, D. Wong, C. Kennedy, J. McLean, P. G. Bannon, and B. C. McCaughan
Extrapleural pneumonectomy for malignant pleural mesothelioma: Outcomes of treatment and prognostic factors
J. Thorac. Cardiovasc. Surg., September 1, 2009; 138(3): 619 - 624.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
M. Ray and H. L. Kindler
Malignant Pleural Mesothelioma: An Update on Biomarkers and Treatment
Chest, September 1, 2009; 136(3): 888 - 896.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
Discussion
J. Thorac. Cardiovasc. Surg., July 1, 2009; 138(1): 31 - 31.
[Full Text] [PDF]

Home page
 JCOHome page
L. M. Krug, H. I. Pass, V. W. Rusch, H. L. Kindler, D. J. Sugarbaker, K. E. Rosenzweig, R. Flores, J. S. Friedberg, K. Pisters, M. Monberg, et al.
Multicenter Phase II Trial of Neoadjuvant Pemetrexed Plus Cisplatin Followed by Extrapleural Pneumonectomy and Radiation for Malignant Pleural Mesothelioma
J. Clin. Oncol., June 20, 2009; 27(18): 3007 - 3013.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
H. Kobayashi, H. Nomori, T. Mori, H. Shibata, K. Yoshimoto, and Y. Ohba
Extrapleural pneumonectomy with reconstruction of diaphragm and pericardium using autologous materials.
Ann. Thorac. Surg., May 1, 2009; 87(5): 1630 - 1632.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
A. S. Tsao, I. Wistuba, J. A. Roth, and H. L. Kindler
Malignant Pleural Mesothelioma
J. Clin. Oncol., April 20, 2009; 27(12): 2081 - 2090.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
M. de Perrot, R. Feld, B.C. J. Cho, A. Bezjak, M. Anraku, R. Burkes, H. Roberts, M. S. Tsao, N. Leighl, S. Keshavjee, et al.
Trimodality Therapy With Induction Chemotherapy Followed by Extrapleural Pneumonectomy and Adjuvant High-Dose Hemithoracic Radiation for Malignant Pleural Mesothelioma
J. Clin. Oncol., March 20, 2009; 27(9): 1413 - 1418.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
L. Zellos, W. G. Richards, L. Capalbo, M. T. Jaklitsch, L. R. Chirieac, B. E. Johnson, R. Bueno, and D. J. Sugarbaker
A phase I study of extrapleural pneumonectomy and intracavitary intraoperative hyperthermic cisplatin with amifostine cytoprotection for malignant pleural mesothelioma.
J. Thorac. Cardiovasc. Surg., February 1, 2009; 137(2): 453 - 458.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
J. B. Sorensen, J. Ravn, A. Loft, J. Brenoe, A. K. Berthelsen, and on behalf of the Nordic Mesothelioma Group
Preoperative staging of mesothelioma by 18F-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography fused imaging and mediastinoscopy compared to pathological findings after extrapleural pneumonectomy
Eur. J. Cardiothorac. Surg., November 1, 2008; 34(5): 1090 - 1096.
[Abstract] [Full Text] [PDF]

Home page
 Clin. Cancer Res.Home page
K. G. Tournoy, S. A. Burgers, J. T. Annema, F. Vermassen, M. Praet, M. Smits, H. M. Klomp, J. P. van Meerbeeck, and P. Baas
Transesophageal Endoscopic Ultrasound with Fine Needle Aspiration in the Preoperative Staging of Malignant Pleural Mesothelioma
Clin. Cancer Res., October 1, 2008; 14(19): 6259 - 6263.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
H. I. Pass, G. J. Brewer, R. Dick, M. Carbone, and S. Merajver
A Phase II Trial of Tetrathiomolybdate After Surgery for Malignant Mesothelioma: Final Results
Ann. Thorac. Surg., August 1, 2008; 86(2): 383 - 390.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
R. M. Flores, H. I. Pass, V. E. Seshan, J. Dycoco, M. Zakowski, M. Carbone, M. S. Bains, and V. W. Rusch
Extrapleural pneumonectomy versus pleurectomy/decortication in the surgical management of malignant pleural mesothelioma: Results in 663 patients
J. Thorac. Cardiovasc. Surg., March 1, 2008; 135(3): 620 - 626.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
J. Huang, G. J. Riely, K. E. Rosenzweig, and V. W. Rusch
Multimodality Therapy for Locally Advanced Thymomas: State of the Art or Investigational Therapy?
Ann. Thorac. Surg., February 1, 2008; 85(2): 365 - 367.
[Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
P. Borasio, A. Berruti, A. Bille, P. Lausi, M. G. Levra, R. Giardino, and F. Ardissone
Malignant pleural mesothelioma: clinicopathologic and survival characteristics in a consecutive series of 394 patients
Eur. J. Cardiothorac. Surg., February 1, 2008; 33(2): 307 - 313.
[Abstract] [Full Text] [PDF]

Home page
 ICVTSHome page
M. Okada, T. Mimura, C. Ohbayashi, T. Sakuma, T. Soejima, and N. Tsubota
Radical surgery for malignant pleural mesothelioma: results and prognosis
Interactive CardioVascular and Thoracic Surgery, February 1, 2008; 7(1): 102 - 106.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
J. Huang, N. P. Rizk, W. D. Travis, V. E. Seshan, M. S. Bains, J. Dycoco, R. J. Downey, R. M. Flores, B. J. Park, and V. W. Rusch
Feasibility of multimodality therapy including extended resections in stage IVA thymoma.
J. Thorac. Cardiovasc. Surg., December 1, 2007; 134(6): 1477 - 1484.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
D. C. Rice, C. W. Stevens, A. M. Correa, A. A. Vaporciyan, A. Tsao, K. M. Forster, G. L. Walsh, S. G. Swisher, W. L. Hofstetter, R. J. Mehran, et al.
Outcomes After Extrapleural Pneumonectomy and Intensity-Modulated Radiation Therapy for Malignant Pleural Mesothelioma
Ann. Thorac. Surg., November 1, 2007; 84(5): 1685 - 1693.
[Abstract] [Full Text] [PDF]

Home page
 ThoraxHome page
British Thoracic Society Standards of Care Committ
BTS statement on malignant mesothelioma in the UK, 2007
Thorax, November 1, 2007; 62(Suppl_2): ii1 - ii19.
[Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
F. Bakaeen, D. Rice, A. M. Correa, G. L. Walsh, A. A. Vaporciyan, J. B. Putnam, S. G. Swisher, J. A. Roth, J. Huh, D. Chu, et al.
Use of Aprotinin in Extrapleural Pneumonectomy: Effect on Hemostasis and Incidence of Complications
Ann. Thorac. Surg., September 1, 2007; 84(3): 982 - 986.
[Abstract] [Full Text] [PDF]

Home page
 Molecular Cancer TherapeuticsHome page
A. S. Tsao, D. He, B. Saigal, S. Liu, J. J. Lee, S. Bakkannagari, N. G. Ordonez, W. K. Hong, I. Wistuba, and F. M. Johnson
Inhibition of c-Src expression and activation in malignant pleural mesothelioma tissues leads to apoptosis, cell cycle arrest, and decreased migration and invasion
Mol. Cancer Ther., July 1, 2007; 6(7): 1962 - 1972.
[Abstract] [Full Text] [PDF]

Home page
 Ann OncolHome page
W Weder, R. Stahel, J Bernhard, S Bodis, P Vogt, P Ballabeni, D Lardinois, D Betticher, R Schmid, R Stupp, et al.
Multicenter trial of neo-adjuvant chemotherapy followed by extrapleural pneumonectomy in malignant pleural mesothelioma
Ann. Onc., July 1, 2007; 18(7): 1196 - 1202.
[Abstract] [Full Text] [PDF]

Home page
 The OncologistHome page
G. L. Ceresoli, C. Gridelli, and A. Santoro
Multidisciplinary Treatment of Malignant Pleural Mesothelioma
Oncologist, July 1, 2007; 12(7): 850 - 863.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
T. Treasure and M. Utley
Ten traps for the unwary in surgical series: A case study in mesothelioma reports
J. Thorac. Cardiovasc. Surg., June 1, 2007; 133(6): 1414 - 1418.
[Full Text] [PDF]

Home page
 JCOHome page
D. S. Higginson, J. Brahmer, R. P. Tufano, and G. K. Bajaj
Pleural Mesothelioma Metastatic to Tongue
J. Clin. Oncol., May 20, 2007; 25(15): 2133 - 2135.
[Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
V. W. Rusch
Editorial comment: A phase II study of intrapleural immunochemotherapy, pleurectomy/decortication, radiotherapy, systemic chemotherapy, and long-term subcutaneous IL-2 in stage II-III malignant pleural mesothelioma
Eur. J. Cardiothorac. Surg., March 1, 2007; 31(3): 534 - 535.
[Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
M. de Perrot, K. Uy, M. Anraku, M. S. Tsao, G. Darling, T. K. Waddell, A. F. Pierre, A. Bezjak, S. Keshavjee, and M. R. Johnston
Impact of lymph node metastasis on outcome after extrapleural pneumonectomy for malignant pleural mesothelioma
J. Thorac. Cardiovasc. Surg., January 1, 2007; 133(1): 111 - 116.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
D. Rice
Reply
Ann. Thorac. Surg., December 1, 2006; 82(6): 2337 - 2338.
[Full Text] [PDF]

Home page
 RadiologyHome page
P. P. Agarwal, J. M. Seely, F. R. Matzinger, R. M. MacRae, R. A. Peterson, D. E. Maziak, and C. J. Dennie
Pleural Mesothelioma: Sensitivity and Incidence of Needle Track Seeding after Image-guided Biopsy versus Surgical Biopsy
Radiology, November 1, 2006; 241(2): 589 - 594.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
D. C. Rice, J. J. Erasmus, C. W. Stevens, A. A. Vaporciyan, J. S. Wu, A. S. Tsao, G. L. Walsh, S. G. Swisher, W. L. Hofstetter, N. G. Ordonez, et al.
Extended Surgical Staging for Potentially Resectable Malignant Pleural Mesothelioma
Ann. Thorac. Surg., December 1, 2005; 80(6): 1988 - 1993.
[Abstract] [Full Text] [PDF]

Home page
 NEJMHome page
M. R. Cullen
Serum osteopontin levels--is it time to screen asbestos-exposed workers for pleural mesothelioma?
N. Engl. J. Med., October 13, 2005; 353(15): 1617 - 1618.
[Full Text] [PDF]

Home page
 JRSMHome page
C. Tan and T. Treasure
Mesothelioma: time to take stock
J R Soc Med, October 1, 2005; 98(10): 455 - 458.
[Full Text] [PDF]

Home page
 Jpn J Clin OncolHome page
R. Maruyama, F. Shoji, T. Okamoto, T. Miyamoto, T. Miyake, T. Nakamura, J. Ikeda, Y. Aoki, H. Wataya, H. Asoh, et al.
Triplet Chemotherapy with Cisplatin, Gemcitabine and Vinorelbine for Malignant Pleural Mesothelioma
Jpn. J. Clin. Oncol., August 1, 2005; 35(8): 433 - 438.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
M. Pistolesi and J. Rusthoven
Malignant Pleural Mesothelioma: Update, Current Management, and Newer Therapeutic Strategies
Chest, October 1, 2004; 126(4): 1318 - 1329.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
W. Weder, P. Kestenholz, C. Taverna, S. Bodis, D. Lardinois, M. Jerman, and R. A. Stahel
Neoadjuvant Chemotherapy Followed by Extrapleural Pneumonectomy in Malignant Pleural Mesothelioma
J. Clin. Oncol., September 1, 2004; 22(17): 3451 - 3457.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
D. J. Stewart, A. Martin-Ucar, J. E. Pilling, J. G. Edwards, K. J. O'Byrne, and D. A. Waller
The effect of extent of local resection on patterns of disease progression in malignant pleural mesothelioma
Ann. Thorac. Surg., July 1, 2004; 78(1): 245 - 252.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
D. J. Sugarbaker, M. T. Jaklitsch, R. Bueno, W. Richards, J. Lukanich, S. J. Mentzer, Y. Colson, P. Linden, M. Chang, L. Capalbo, et al.
Prevention, early detection, and management of complications after 328 consecutive extrapleural pneumonectomies
J. Thorac. Cardiovasc. Surg., July 1, 2004; 128(1): 138 - 146.
[Abstract] [Full Text] [PDF]

Home page
 Molecular Cancer TherapeuticsHome page
M. K. Ozvaran, X. X. Cao, S. D. Miller, B. A. Monia, W. K. Hong, and W. R. Smythe
Antisense oligonucleotides directed at the bcl-xl gene product augment chemotherapy response in mesothelioma
Mol. Cancer Ther., May 1, 2004; 3(5): 545 - 550.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
D. Stewart, D. Waller, J. Edwards, K. Jeyapalan, and J. Entwisle
Is there a role for pre-operative contrast-enhanced magnetic resonance imaging for radical surgery in malignant pleural mesothelioma?
Eur. J. Cardiothorac. Surg., December 1, 2003; 24(6): 1019 - 1024.
[Abstract] [Full Text] [PDF]

Home page
 JCOHome page
V. W. Rusch
Pemetrexed and Cisplatin for Malignant Pleural Mesothelioma: A New Standard of Care?
J. Clin. Oncol., July 15, 2003; 21(14): 2629 - 2630.
[Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
R. M. Flores, T. Akhurst, M. Gonen, S. M. Larson, and V. W. Rusch
Positron emission tomography defines metastatic disease but not locoregional disease in patients with malignant pleural mesothelioma
J. Thorac. Cardiovasc. Surg., July 1, 2003; 126(1): 11 - 15.
[Abstract] [Full Text] [PDF]

Home page
 Clin. Cancer Res.Home page
P. B. Illei, V. W. Rusch, M. F. Zakowski, and M. Ladanyi
Homozygous Deletion of CDKN2A and Codeletion of the Methylthioadenosine Phosphorylase Gene in the Majority of Pleural Mesotheliomas
Clin. Cancer Res., June 1, 2003; 9(6): 2108 - 2113.
[Abstract] [Full Text] [PDF]

Home page
 ICVTSHome page
P. G. Phillips, G. Asimakopoulos, and M. O. Maiwand
Malignant pleural mesothelioma: outcome of limited surgical management
Interactive CardioVascular and Thoracic Surgery, March 1, 2003; 2(1): 30 - 34.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
H. I. Pass
Pleural mesothelioma in 2002: Going somewhere very slowly
J. Thorac. Cardiovasc. Surg., December 1, 2002; 124(6): 1074 - 1077.
[Full Text]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
T. T. Lee, D. L. Everett, H.-K. G. Shu, T. M. Jahan, M. Roach III, J. L. Speight, R. B. Cameron, T. L. Phillips, A. Chan, and D. M. Jablons
Radical pleurectomy/decortication and intraoperative radiotherapy followed by conformal radiation with or without chemotherapy for malignant pleural mesothelioma
J. Thorac. Cardiovasc. Surg., December 1, 2002; 124(6): 1183 - 1189.
[Abstract] [Full Text]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2001 by The American Association for Thoracic Surgery.