Journal article
Prospective study on functional results after lung-sparing radical pleurectomy in the management of malignant pleural mesothelioma
Journal of thoracic oncology, Vol.7(5), pp.900-905
05/2012
DOI: 10.1097/JTO.0b013e31824de2dc
PMID: 22722790
Abstract
Malignant pleural mesothelioma (MPM) can reduce lung function by entrapping lung parenchyma via a rind of tumor with or without concurrent effusion. Radical pleurectomy (RP) allows expansion of the trapped lung. The purpose of this study was to investigate changes in pulmonary function and lung perfusion in patients undergoing RP.
In a prospective, nonrandomized study, all patients with histologically proven MPM were evaluated from January to December 2010 for trimodality therapy including RP as surgical procedure. Pulmonary-function tests and perfusion scans were obtained before and 2 months after RP. Primary end points were pulmonary function (forced vital capacity [FVC], forced expiratory volume in 1 second [FEV1]) and ipsilateral lung perfusion.
Sixteen out of 25 consecutive patients (age 68.8±8.9 years) were enrolled in the study. Macroscopic complete resection could be achieved in 13 patients (81.3%). Diaphragm resection was necessary in 5 patients. Significant postsurgical improvement of pulmonary function at 2 months was observed for FVC and FEV1 (both absolute and percentage of predicted values) and ipsilateral perfusion (p < 0.001). Avoidance of diaphragm resection was associated with greater increase in FVC (+34.6±17.0% versus +13.5±5.4%; p = 0.002) and FEV1 (+29.2±18.1% versus +12.1±6.4%; p = 0.015), respectively.
Lung-sparing RP leads to significant improvement of pulmonary function and perfusion after a recovery time of 2 months. Functional results are better after preservation of the diaphragm. Preservation of physiological reserve via lung-sparing RP might allow patients with MPM to be eligible for further therapeutic options in the long term.
Details
- Title: Subtitle
- Prospective study on functional results after lung-sparing radical pleurectomy in the management of malignant pleural mesothelioma
- Creators
- Servet Bölükbas - Department of Thoracic Surgery, Dr.-Horst-Schmidt-Klinik (Teaching Hospital of Johannes Gutenberg University, Mainz), Wiesbaden, Germany. Dr.Bolukbas@gmx.deMichael EberleinJoachim Schirren
- Resource Type
- Journal article
- Publication Details
- Journal of thoracic oncology, Vol.7(5), pp.900-905
- DOI
- 10.1097/JTO.0b013e31824de2dc
- PMID
- 22722790
- ISSN
- 1556-0864
- eISSN
- 1556-1380
- Language
- English
- Date published
- 05/2012
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; Internal Medicine
- Record Identifier
- 9984094602802771
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