Pleuropneumonectomy in the Treatment of Malignant Pleural …

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pleural mesothelioma: results in 120 consecutive patients. Ann Surg 1996; 224:288-296. 22 Kaiser LR. New therapies in the treatment of malignant …

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DOI 10.1378/chest.116.suppl_3.450S
Chest 1999;116;450-454
Sean C. Grondin and David J. Sugarbaker
Malignant Pleural Mesothelioma *
Pleuropneumonectomy in the Treatment of
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Downloaded from chestjournal.org on November 5, 2007Pleuropneumonectomy in the
Treatment of Malignant Pleural
Mesothelioma*
Sean C. Grondin, MD; and David J. Sugarbaker, MD, FCCP
Study objectives: Malignant pleural mesothelioma
(MPM) is predominantly a local/regional disease that
results in a survival time that ranges from 4 to 12
months without treatment. Single-modality therapy
using surgery, chemotherapy, or radiotherapy alone
is largely ineffective. The objective of the study was
presentation of the use of pleuropneumonectomy in
a multimodality treatment setting and the results.
Design: Didactic presentation.
Setting: Academic tertiary-care hospital.
Patients: One hundred eighty-three patients who
underwent multimodality therapy.
Interventions: Of all the single-modality treatment
approaches, pleuropneumonectomy has been associated
most consistently with long-term disease-free
survival and has provided the greatest amount of
tumor cytoreduction. The technique of pleuropneumonectomy
traditionally has been linked with high
perioperative mortality and morbidity when compared
with that of other cytoreductive techniques
such as pleurectomy/decortication. Recently, improvements
in operative mortality (< 5%) have been
reported, largely due to improvements in patient
selection and perioperative management. Multimodality
therapy, including chemotherapy, radiotherapy,
and extrapleural pneumonectomy, was used to
treat patients.
Results: Outcomes were presented for 183 patients
with MPM who underwent multimodality therapy.
Conclusions: With the...