| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
J Thorac Cardiovasc Surg 2001;122:788-795
© 2001 The American Association for Thoracic Surgery
General Thoracic Surgery |
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:
|
|
 |
|
  J. W. van Sandick, I. Kappers, P. Baas, R. L. Haas, and H. M. Klomp Surgical Treatment in the Management of Malignant Pleural Mesothelioma: A Single Institution's Experience Ann. Surg. Oncol., June 1, 2008; 15(6): 1757 - 1764. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 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]
|
|
|
|
 |
|
 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]
|
|
|
|
 |
|
 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]
|
|
|
|
 |
|
 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]
|
|
|
|
|
|
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]
|
|
|
|
|
|
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]
|
|
|
|
 |
|
 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]
|
|
|
|
|
|
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]
|
|
|
|
 |
|
 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]
|
|
|
|
 |
|
 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]
|
|
|
|
 |
|
 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]
|
|
|
|
|
|
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]
|
|
|
|
 |
|
 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]
|
|
|
|
|
|
R. B. Cameron Extrapleural Pneumonectomy Is the Preferred Surgical Management in the Multimodality Therapy of Pleural Mesothelioma: Con Argument Ann. Surg. Oncol., April 1, 2007; 14(4): 1249 - 1253. [Full Text] [PDF]
|
|
|
|
|
|
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]
|
|
|
|
|
|
P. S. Adusumilli, M.-K. Chan, M. Hezel, Z. Yu, B. M. Stiles, T.-C. Chou, V. W. Rusch, and Y. Fong Radiation-Induced Cellular DNA Damage Repair Response Enhances Viral Gene Therapy Efficacy in the Treatment of Malignant Pleural Mesothelioma Ann. Surg. Oncol., January 1, 2007; 14(1): 258 - 269. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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]
|
|
|
|
|
|
D. Rice Reply Ann. Thorac. Surg., December 1, 2006; 82(6): 2337 - 2338. [Full Text] [PDF]
|
|
|
|
 |
|
 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]
|
|
|
|
|
|
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]
|
|
|
|
 |
|
 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]
|
|
|
|
 |
|
 C. Tan and T. Treasure Mesothelioma: time to take stock J R Soc Med, October 1, 2005; 98(10): 455 - 458. [Full Text] [PDF]
|
|
|
|
 |
|
 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]
|
|
|
|
 |
|
 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]
|
|
|
|
|
|
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]
|
|
|
|
|
|
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]
|
|
|
|
|
|
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]
|
|
|
|
|
|
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]
|
|
|
|
|
|
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]
|
|
|
|
|
|
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]
|
|
|
|
|
|
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]
|
|
|
|
 |
|
 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]
|
|
|
|
|
|
W.R. Smythe and P.F. Mansfield Hyperthermia: Has Its Time Come? Ann. Surg. Oncol., April 1, 2003; 10(3): 210 - 212. [Full Text] [PDF]
|
|
|
|
|
|
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]
|
|
|
|
|
|
S. van Ruth, P. Baas, R.L. M. Haas, E.J. Th. Rutgers, V.J. Verwaal, and F.A. N. Zoetmulder Cytoreductive Surgery Combined With Intraoperative Hyperthermic Intrathoracic Chemotherapy for Stage I Malignant Pleural Mesothelioma Ann. Surg. Oncol., March 1, 2003; 10(2): 176 - 182. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. I. Pass Pleural mesothelioma in 2002: Going somewhere very slowly J. Thorac. Cardiovasc. Surg., December 1, 2002; 124(6): 1074 - 1077. [Full Text]
|
|
|
|
|
|
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 |
