title: Quality of life after radical pleurectomy decortication for malignant pleural mesothelioma.
abstract: BACKGROUND
  Malignant pleural mesothelioma is an aggressive malignancy in which radical surgical treatment appears to improve survival. It is unknown, however, if radical surgical treatment affects quality of life (QoL) adversely. Our objective was to assess patient-reported symptoms of health-related QoL after radical pleurectomy decortication (PD).
  
  
  METHODS
  Patients with malignant pleural mesothelioma were prospectively enrolled between 2010 and 2011 to determine the effects of PD on baseline QoL. Health-related QoL was assessed using the European Organization for Research and Treatment of Cancer core Quality of Life Questionnaire-C30 tool (EORTC QLQ-C30) before operation and at 1, 5 to 6, and 8 to 9 months postoperatively. Patients were grouped based on World Health Organization baseline performance status (PS) and compared.
  
  
  RESULTS
  Of the 28 patients enrolled, 16 (57.1%) and 12 (42.9%) were World Health Organization PS 0 and PS 1, respectively. At baseline, PS 1 patients had significantly worse global QoL functional and symptom scores at baseline. At 5 to 6 months' follow-up, PS 0 patients had no significant change in global QoL or functional domain scores. PS 1 patients had significant improvement in global QoL (p=0.038), symptoms of fatigue (p=0.05), and dyspnea (p=0.048). At 8 to 9 months' follow-up, PS 0 patients showed significant improvement in symptoms of fatigue (p=0.026) from baseline and PS 1 maintained the improvements in symptoms of fatigue (p=0.049) and dyspnea (p=0.048).
  
  
  CONCLUSIONS
  Radical PD does not negatively impact minimally symptomatic patients at intermediate follow-up. Patients who have symptoms at baseline can have significant improvement in their QoL after surgical treatment.
authors.affiliation: Department of Surgery, University of Illinois, Mount Sinai Hospital, Chicago, IL 60637, USA.
authors.forename: Nathan M
authors.initials: NM
authors.lastname: Mollberg
authors.forename: Yalini
authors.initials: Y
authors.lastname: Vigneswaran
authors.forename: Hedy L
authors.initials: HL
authors.lastname: Kindler
authors.forename: Cynthia
authors.initials: C
authors.lastname: Warnes
authors.forename: Ravi
authors.initials: R
authors.lastname: Salgia
authors.forename: Aliyah N
authors.initials: AN
authors.lastname: Husain
authors.forename: Wickii T
authors.initials: WT
authors.lastname: Vigneswaran
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008654:Mesothelioma / Q000175:diagnosis / Q000523:psychology / Q000601:surgery*; D008875:Middle Aged; D010994:Pleura / Q000601:surgery*; D010997:Pleural Neoplasms / Q000175:diagnosis / Q000523:psychology / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D019616:Thoracic Surgical Procedures / Q000379:methods / Q000523:psychology*; D016896:Treatment Outcome