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An Investigation of Cancer-Directed Surgery for Different Histologic Subtypes of Malignant Pleural Mesothelioma.

Publication ,  Journal Article
Mansur, A; Potter, AL; Zurovec, AJ; Nathamuni, KV; Meyerhoff, RR; Berry, MF; Kang, A; Jeffrey Yang, C-F
Published in: Chest
May 2023

The role of cancer-directed surgery in the treatment of stage I-IIIA malignant pleural mesothelioma (MPM) by histologic subtypes remains controversial. The objective of this study was to evaluate the survival of the different histologic subtypes for stage I-IIIA MPM stratified by cancer-directed surgery and nonoperative management.How is the histologic subtype, clinical stage, and use of cancer-directed surgery for MPM associated with overall survival?Overall survival of patients with stage I-IIIA epithelioid, sarcomatoid, and biphasic MPM in the National Cancer Database from 2004 through 2017 who underwent cancer-directed surgery (ie, surgery with or without chemotherapy or radiation) or chemotherapy with or without radiation (nonoperative management) was evaluated using Kaplan-Meier analysis, multivariable Cox proportional hazards analysis, and propensity score-matched analysis.Of 2,285 patients with stage I-IIIA MPM who met inclusion criteria, histologic subtype was epithelioid in 71% of patients, sarcomatoid in 12% of patients, and biphasic in 17% of patients. Median survival was 20 months in the epithelioid group, 8 months in the sarcomatoid group, and 13 months in the biphasic group (P < .01). Among patients who underwent surgery, median survival was 25 months in the epithelioid group, 8 months in the sarcomatoid group, and 15 months in the biphasic group (P < .01). In multivariable Cox proportional hazards analyses, surgery was associated with improved survival in the epithelioid group (P < .01) but not in the sarcomatoid (P = .63) or biphasic (P = .21) groups. These findings were consistent in propensity score-matched analyses for each MPM histologic type.In this national analysis, cancer-directed surgery was found to be associated with improved survival for stage I-IIIA epithelioid MPM, but not for biphasic or sarcomatoid MPM.

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Published In

Chest

DOI

EISSN

1931-3543

ISSN

0012-3692

Publication Date

May 2023

Volume

163

Issue

5

Start / End Page

1292 / 1303

Related Subject Headings

  • Sarcoma
  • Respiratory System
  • Prognosis
  • Pleural Neoplasms
  • Mesothelioma, Malignant
  • Mesothelioma
  • Lung Neoplasms
  • Kaplan-Meier Estimate
  • Humans
  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Mansur, A., Potter, A. L., Zurovec, A. J., Nathamuni, K. V., Meyerhoff, R. R., Berry, M. F., … Jeffrey Yang, C.-F. (2023). An Investigation of Cancer-Directed Surgery for Different Histologic Subtypes of Malignant Pleural Mesothelioma. Chest, 163(5), 1292–1303. https://doi.org/10.1016/j.chest.2022.12.019
Mansur, Arian, Alexandra L. Potter, Alexander J. Zurovec, Krithika V. Nathamuni, R Ryan Meyerhoff, Mark F. Berry, Augustine Kang, and Chi-Fu Jeffrey Yang. “An Investigation of Cancer-Directed Surgery for Different Histologic Subtypes of Malignant Pleural Mesothelioma.Chest 163, no. 5 (May 2023): 1292–1303. https://doi.org/10.1016/j.chest.2022.12.019.
Mansur A, Potter AL, Zurovec AJ, Nathamuni KV, Meyerhoff RR, Berry MF, et al. An Investigation of Cancer-Directed Surgery for Different Histologic Subtypes of Malignant Pleural Mesothelioma. Chest. 2023 May;163(5):1292–303.
Mansur, Arian, et al. “An Investigation of Cancer-Directed Surgery for Different Histologic Subtypes of Malignant Pleural Mesothelioma.Chest, vol. 163, no. 5, May 2023, pp. 1292–303. Epmc, doi:10.1016/j.chest.2022.12.019.
Mansur A, Potter AL, Zurovec AJ, Nathamuni KV, Meyerhoff RR, Berry MF, Kang A, Jeffrey Yang C-F. An Investigation of Cancer-Directed Surgery for Different Histologic Subtypes of Malignant Pleural Mesothelioma. Chest. 2023 May;163(5):1292–1303.

Published In

Chest

DOI

EISSN

1931-3543

ISSN

0012-3692

Publication Date

May 2023

Volume

163

Issue

5

Start / End Page

1292 / 1303

Related Subject Headings

  • Sarcoma
  • Respiratory System
  • Prognosis
  • Pleural Neoplasms
  • Mesothelioma, Malignant
  • Mesothelioma
  • Lung Neoplasms
  • Kaplan-Meier Estimate
  • Humans
  • 3202 Clinical sciences