Improving Survival Results after Surgical Management of Malignant Pleural Mesothelioma : An Australian Institution Experience
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概要
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Background: There has been an evolving role of surgery for malignant pleural mesothelioma (MPM) over the past 25 years. The objective of this study was to investigate whether the survival results for MPM patients after surgery have improved within this time period by an analysis of a prospective cohort of 540 patients.Methods: Five hundred and forty consecutive patients with MPM were treated by a thoracic surgical team. These patients were categorized into two groups: Group I (before September 1999, n = 270) and Group II (after September 1999, n = 270). The two groups were compared for clinicopathologic data and survival results. The statistical analyses of all prognostic parameters used overall survival as the endpoint.Results: Group II had higher proportions of epithelial tumors and patients who had preoperative PET scan, extrapleural pneumonectomy (EPP), postoperative radiotherapy and pemetrexed chemotherapy. The overall survival results were significantly better in Group II compared with Group I (p = 0.004). Four factors were found to be independently associated with an improved survival in multivariate analysis: epithelial subtype (p <0.001); surgeon’s experience with >100 cases (p = 0.006), patients who underwent EPP (p = 0.001) and those who received pemetrexed chemotherapy (p = 0.016). The median survival for patients selected for EPP was 20 months, as compared to 9 months for pleurodesis/decortication and pleurodesis.Conclusions: Significant improvement of overall survival results has been achieved in the more recent 270 MPM patients through accumulated experience in a specialist treatment center.
- 2011-06-01
著者
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Mccaughan Brian
Department Of Cardiothoracic Surgery Royal Prince Alfred Hospital
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Cao Christopher
Department Of Cardiothoracic Surgery The University Of Sydney The Royal Prince Alfred Hospital
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YAN Tristan
Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital
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BOYER Michael
Department of Medical Oncology, Royal Prince Alfred Hospital
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TIN Mo
Sydney Cancer Center
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KENNEDY Catherine
Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital
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MCLEAN Jocelyn
Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital
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BANNON Paul
Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital
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Bannon Paul
Department Of Cardiothoracic Surgery The University Of Sydney The Royal Prince Alfred Hospital
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Yan Tristan
Department Of Cardiothoracic Surgery The University Of Sydney The Royal Prince Alfred Hospital
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Boyer Michael
Department Of Medical Oncology Royal Prince Alfred Hospital
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Mclean Jocelyn
Department Of Cardiothoracic Surgery Royal Prince Alfred Hospital
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Kennedy Catherine
Department Of Cardiothoracic Surgery Royal Prince Alfred Hospital
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Bannon Paul
Department Of Cardiothoracic Surgery Royal Prince Alfred Hospital The University Of Sydney
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Cao Christopher
Department Of Cardiothoracic Surgery Royal Prince Alfred Hospital The University Of Sydney
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Yan Tristan
Department Of Cardiothoracic Surgery Royal Prince Alfred Hospital The University Of Sydney
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