| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Eur J Cardiothorac Surg 2004;25:497-501
© 2004 Elsevier Science NL
a Department of Thoracic surgery, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK
b Department of Pathology, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK
c Department of Oncology, Glenfield Hospital, Groby Road, Leicester LE3 9QP, UK
Received 6 September 2003; received in revised form 25 November 2003; accepted 1 December 2003.
* Corresponding author. Tel.: +44-116-256-3959; fax: +44-116-236-7768
e-mail: debra.grew{at}uhl-tr.nhs.uk
Objectives: To assess whether cervical mediastinoscopy is necessary before radical resection of malignant pleural mesothelioma (MPM). Methods: Patients who underwent radical excision of MPM in a 48-month period were prospectively followed for evidence of disease recurrence and death. Histological evidence of extra pleural lymph node metastases was correlated with survival. Lymph node size at intraoperative lymphadenectomy was correlated with the presence of metastatic tumour. Results: The 55 patients who underwent radical resection (51 extra pleural pneumonectomies and 4 radical pleurectomies) comprised 50 men and 5 women with a median age of 58 years, range 41–70. Histological examination revealed 50 epithelioid, four biphasic and one sarcomatoid histology. Postoperative IMIG T stage was stage I 4, II 11, III 30 and IV 10. Postoperatively the 17 patients with metastases to the extra pleural lymph nodes had significantly shorter survival (median 4.4 months, 95% CI 3.2–5.4) than those without (median survival 16.3 months, 95% CI 11.6–21.0) P=0.012 Kaplan–Meier analysis. Seventy-seven extra pleural lymph nodes without metastases were measured with a mean long axis diameter of 16.9 mm (range 4–55); 22 positive nodes had a mean long axis diameter of 15.2 mm (range 6–30). In 15 of the 17 patients with positive extra pleural nodes, the nodes could have been biopsied at cervical mediastinoscopy. Conclusions: This study confirms that extra pleural nodal metastases are related to poor survival. Pathological nodal involvement cannot be predicted from nodal dimensions. These data suggest that all patients being considered for radical resection of MPM should preferentially undergo preoperative cervical mediastinoscopy irrespective of radiological findings.
Key Words: Malignant pleural mesothelioma • Staging • Thoracic surgery • Lymph nodes
This article has been cited by other articles:
|
|
 |
|
  D. C. Rice, M. A. Steliga, J. Stewart, G. Eapen, C. A. Jimenez, J. H. Lee, W. L. Hofstetter, E. M. Marom, R. J. Mehran, A. A. Vaporciyan, et al. Endoscopic ultrasound-guided fine needle aspiration for staging of malignant pleural mesothelioma. Ann. Thorac. Surg., September 1, 2009; 88(3): 862 - 868. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Nakas, D. S. Trousse, A. E. Martin-Ucar, and D. A. Waller Open lung-sparing surgery for malignant pleural mesothelioma: the benefits of a radical approach within multimodality therapy Eur. J. Cardiothorac. Surg., October 1, 2008; 34(4): 886 - 891. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. G. Tournoy, S. A. Burgers, J. T. Annema, F. Vermassen, M. Praet, M. Smits, H. M. Klomp, J. P. van Meerbeeck, and P. Baas Transesophageal Endoscopic Ultrasound with Fine Needle Aspiration in the Preoperative Staging of Malignant Pleural Mesothelioma Clin. Cancer Res., October 1, 2008; 14(19): 6259 - 6263. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. R. M. Abdel Rahman, R. M. Gaafar, H. A. Baki, H. M. El Hosieny, F. Aboulkasem, E. G. Farahat, A. M. Nouh, and K. A. Mansour Prevalence and Pattern of Lymph Node Metastasis in Malignant Pleural Mesothelioma Ann. Thorac. Surg., August 1, 2008; 86(2): 391 - 395. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. H. Chamberlain, K. Fareed, A. Nakas, A. E. Martin-Ucar, and D. A. Waller Video-assisted cervical thoracoscopy: a novel approach for diagnosis, staging and pleurodesis of malignant pleural mesothelioma. Eur. J. Cardiothorac. Surg., July 1, 2008; 34(1): 200 - 203. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. C. Mineo, V. Ambrogi, E. Pompeo, A. Baldi, F. Stella, P. Aurea, and M. Marino The Value of Occult Disease in Resection Margin and Lymph Node After Extrapleural Pneumonectomy for Malignant Mesothelioma Ann. Thorac. Surg., May 1, 2008; 85(5): 1740 - 1746. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Nakas, A. E. Martin Ucar, J. G. Edwards, and D. A. Waller The role of video assisted thoracoscopic pleurectomy/decortication in the therapeutic management of malignant pleural mesothelioma Eur. J. Cardiothorac. Surg., January 1, 2008; 33(1): 83 - 88. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. G. Edwards, A. E. Martin-Ucar, D. J. Stewart, and D. A. Waller Right extrapleural pneumonectomy for malignant mesothelioma via median sternotomy or thoracotomy?: Short- and long-term results Eur. J. Cardiothorac. Surg., May 1, 2007; 31(5): 759 - 764. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. E. Martin-Ucar, A. Nakas, J. G. Edwards, and D. A. Waller Case-control study between extrapleural pneumonectomy and radical pleurectomy/decortication for pathological N2 malignant pleural mesothelioma Eur. J. Cardiothorac. Surg., May 1, 2007; 31(5): 765 - 770. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. de Perrot, K. Uy, M. Anraku, M. S. Tsao, G. Darling, T. K. Waddell, A. F. Pierre, A. Bezjak, S. Keshavjee, and M. R. Johnston Impact of lymph node metastasis on outcome after extrapleural pneumonectomy for malignant pleural mesothelioma J. Thorac. Cardiovasc. Surg., January 1, 2007; 133(1): 111 - 116. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. S. Adusumilli, D. P. Eisenberg, B. M. Stiles, S. Chung, M.-K. Chan, V. W. Rusch, and Y. Fong Intraoperative localization of lymph node metastases with a replication-competent herpes simplex virus. J. Thorac. Cardiovasc. Surg., November 1, 2006; 132(5): 1179 - 1188. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. P Clarke, S. R Knight, F. J Daniel, and S. Seevanayagam Management of Malignant Mesothelioma by Decortication and Adjunct Phototherapy Asian Cardiovasc Thorac Ann, June 1, 2006; 14(3): 206 - 209. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. G. Edwards, D.J. Stewart, A. Martin-Ucar, S. Muller, C. Richards, and D. A. Waller The pattern of lymph node involvement influences outcome after extrapleural pneumonectomy for malignant mesothelioma J. Thorac. Cardiovasc. Surg., May 1, 2006; 131(5): 981 - 987. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. E. Martin-Ucar, D. J. Stewart, K. J. West, and D. A. Waller A Median Sternotomy Approach to Right Extrapleural Pneumonectomy for Mesothelioma Ann. Thorac. Surg., September 1, 2005; 80(3): 1143 - 1145. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. J. Stewart, A. E. Martin-Ucar, J. G. Edwards, K. West, and D. A. Waller Extra-pleural pneumonectomy for malignant pleural mesothelioma: the risks of induction chemotherapy, right-sided procedures and prolonged operations Eur. J. Cardiothorac. Surg., March 1, 2005; 27(3): 373 - 378. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
