Thoracic Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Padova University Hospital, Padova, Italy.
Expert Rev Respir Med. 2020 Jan;14(1):67-79. doi: 10.1080/17476348.2020.1688147. Epub 2019 Nov 13.
: Malignant pleural mesothelioma (MPM) is a fatal malignancy for which there is no definitive cure. The most effective multimodality treatment in prolonging survival is still matter of debate. Surgery remains one of the cornerstones in the multimodality therapy for MPM. Extra-pleural pneumonectomy and pleurectomy/decortication are the two main curative-intent procedures; however, the superiority of one technique over the other is still debated. This review aims to assess short- and long-term results of extrapleural pneumonectomy for MPM.: This article focuses on the role of extrapleural pneumonectomy in MPM. A systematic review was performed by using electronic databases to identify studies that included patients treated by this procedure for MPM. Endpoints included overall survival, disease-free survival, recurrence rate, perioperative mortality, and morbidity.: This paper offers an overview of the results that are currently obtained in patients undergoing extrapleural pneumonectomy for MPM. The benefit of surgical treatments in MPM is still debated and its primary goal should be the achievement of a macroscopic complete resection. Several alternative multimodality protocols exist, with specific advantages and drawbacks; therefore, individualization of care for each patient is fundamental. The complexity of the surgical treatment mandates that patients be referred to specialized centers.
恶性胸膜间皮瘤(MPM)是一种致命的恶性肿瘤,目前尚无明确的治愈方法。在延长生存期方面,最有效的多模式治疗方法仍存在争议。手术仍然是 MPM 多模式治疗的基石之一。胸膜外全肺切除术和胸膜切除术/剥脱术是两种主要的根治性手术;然而,一种技术优于另一种技术的观点仍存在争议。本综述旨在评估胸膜外全肺切除术治疗 MPM 的短期和长期结果。
本文重点介绍胸膜外全肺切除术在 MPM 中的作用。通过使用电子数据库进行系统评价,确定了包括接受该手术治疗 MPM 的患者在内的研究。终点包括总生存期、无病生存期、复发率、围手术期死亡率和发病率。
本文概述了目前接受胸膜外全肺切除术治疗 MPM 的患者的结果。手术治疗在 MPM 中的益处仍存在争议,其主要目标应该是实现宏观完全切除。目前存在几种不同的多模式治疗方案,各有优缺点;因此,为每个患者提供个体化治疗至关重要。手术治疗的复杂性要求患者转至专门的中心。