title: Extrapleural pneumonectomy for diffuse, malignant mesothelioma.
abstract: Extrapleural pneumonectomy for malignant mesothelioma is a radical procedure that entails en bloc removal of the parietal pleura, lung, pericardium, and diaphragm. Minimal tumor remains after this procedure; palliation and occasional long-term survival may be achieved in properly selected patients. Extrapleural pneumonectomy for diffuse, malignant mesothelioma was done in 33 patients (27 male and 6 female) with 18 procedures on the left side and 15 on the right. There was a history of exposure to asbestos in 16 (48%) of the patients. Histological classification revealed that 20 tumors were epithelial, 10 were mixed, and 3 were sarcomatous. Good palliation, defined as survival for 24 months with a return to fairly normal activities, was obtained in 8 patients (24%) and survival for 36 months was achieved in 5 patients. Three patients died of the disease at 59 months, 60 months, and 82 months. There were 3 operative deaths (9.1%), and serious postoperative complications occurred in 8 patients (24%). Postoperative adjunctive therapy consisting of chemotherapy or irradiation or both was given to approximately one-half of the patients. These findings indicate that extrapleural pneumonectomy for malignant mesothelioma can be done with an acceptable morbidity and mortality. Palliation is achieved in 24% of patients, and there may be an occasional long-term survivor.
mesh_terms: D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D003964:Diaphragm / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008654:Mesothelioma / Q000401:mortality* / Q000601:surgery*; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods; D010496:Pericardium / Q000601:surgery; D010994:Pleura / Q000601:surgery*; D010997:Pleural Neoplasms / Q000401:mortality / Q000601:surgery*; D011013:Pneumonectomy / Q000379:methods* / Q000401:mortality; D011093:Polyethylene Terephthalates; D011182:Postoperative Care / Q000379:methods; D019736:Prostheses and Implants
chemical_list: D011093:Polyethylene Terephthalates