Miyazaki Takuro, Yamasaki Naoya, Tsuchiya Tomoshi, Matsumoto Keitaro, Kamohara Ryotaro, Hatachi Go, Nagayasu Takeshi
Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan.
Ann Thorac Cardiovasc Surg. 2018 Apr 20;24(2):81-88. doi: 10.5761/atcs.oa.17-00192. Epub 2018 Jan 23.
This study was performed to compare the outcome of pleurectomy/decortication (P/D) with that of extrapleural pneumonectomy (EPP) for patients with malignant pleural mesothelioma (MPM).
Patients with MPM underwent either P/D or EPP from August 2008 to December 2014. Various clinicopathological factors were analyzed to identify differences between the two procedures.
P/D was performed in nine patients and EPP in 30 patients. Most of the patients' background characteristics were not significantly different between the groups. The surgery time (680 vs. 586 min, p = 0.0034) and bleeding volume (4050 vs. 2110 mL, p = 0.002) were significantly greater in P/D than in EPP; however, grade ≥3 complications (44% vs. 33%, p = 0.54) and length of postoperative hospital stay (29 vs. 37 days, p = 0.26) were not significantly different. The median survival time and 2- and 3-year survival rates in all patients were 16.7 months, 28.5%, and 15.3%, respectively. The median survival time and 2- and 3-year survival in the P/D and EPP groups were 22.5 months, 43.8%, and 43.8% and 16.5 months, 24.0%, and 14.4%, respectively (p = 0.13).
Survival of patients with MPM remains poor despite multidisciplinary treatment. P/D is comparable with EPP and could be a safe and another surgical treatment for patients with MPM.
本研究旨在比较胸膜切除术/纤维板剥脱术（P/D）与胸膜外全肺切除术（EPP）治疗恶性胸膜间皮瘤（MPM）患者的疗效。
2008年8月至2014年12月期间，MPM患者接受了P/D或EPP手术。分析了各种临床病理因素以确定两种手术之间的差异。
9例患者接受了P/D手术，30例患者接受了EPP手术。两组患者的大多数背景特征无显著差异。P/D组的手术时间（680分钟对586分钟，p = 0.0034）和出血量（4050毫升对2110毫升，p = 0.002）显著高于EPP组；然而，≥3级并发症（44%对33%，p = 0.54）和术后住院时间（29天对37天，p = 0.26）无显著差异。所有患者的中位生存时间以及2年和3年生存率分别为16.7个月、28.5%和15.3%。P/D组和EPP组的中位生存时间以及2年和3年生存率分别为22.5个月、43.8%、43.8%和16.5个月、24.0%、14.4%（p = 0.13）。
尽管采用了多学科治疗，MPM患者的生存率仍然很低。P/D与EPP疗效相当，对于MPM患者可能是一种安全的另一种手术治疗方法。
