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J Thorac Cardiovasc Surg 2005;130:905-906
© 2005 The American Association for Thoracic Surgery

Brief Communication

Importance of mediastinoscopy, bilateral thoracoscopy, and laparoscopy in correct staging of malignant mesothelioma before extrapleural pneumonectomy

^a Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Perth, Australia
^b Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Australia
^c Department of Nuclear Medicine, Sir Charles Gairdner Hospital, Perth, Australia
^d Department of Radiology, Sir Charles Gairdner Hospital, Perth, Australia
^e Department of Oncology, Sir Charles Gairdner Hospital, Perth, Australia

Received for publication December 22, 2004; accepted for publication February 8, 2005.

^_* Address for reprints: J. M. Alvarez, FRACS, Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Nedlands 6009, Perth, West Australia, Australia.

The first 20% of the full text of this article appears below.

For selected patients with malignant mesothelioma, treatment with extrapleural pneumonectomy (EPP), chemotherapy, and hemithoracic irradiation (trimodality therapy) appears to confer improved survival relative to other treatment options. ¹ Sugarbaker and colleagues ¹ demonstrated a 5-year survival of 46%, with a median survival of 51 months, for patients with epithelial histologic type, negative extrapleural nodes, and negative resection margins. We therefore offer trimodality therapy to selected patients with stage 1 (limited to one hemithorax) epithelial malignant mesothelioma. All patients have preoperative computed tomographic (CT), magnetic resonance imaging (MRI), and positron emission tomographic (PET) scans. ^1,2 However, EPP is only offered to those with histologically confirmed negative results of biopsy examinations of the mediastinum, contralateral pleura, and diaphragmatic peritoneum.

Clinical Summary

A 67-year-old woman was incidentally discovered to have a right pleural effusion. Cytologic examination confirmed malignant mesothelioma. CT, MRI, and PET scans (Figure 1, A-C. . . [Full Text of this Article]

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