Scholars@Duke publication: The Impact of Adjuvant Hemithoracic Radiation on Outcomes in Patients With Stage I-III Malignant Pleural Mesothelioma: A Dual Registry Analysis.

The Impact of Adjuvant Hemithoracic Radiation on Outcomes in Patients With Stage I-III Malignant Pleural Mesothelioma: A Dual Registry Analysis.

Publication , Journal Article

Raman, V; Voigt, SL; Jawitz, OK; Farrow, NE; Rhodin, KE; Yang, C-FJ; Tong, BC; D'Amico, TA; Harpole, DH

Published in: Ann Surg

March 1, 2023

BACKGROUND: The outcomes associated with receipt of adjuvant radiation in patients after surgery for MPM are poorly understood. OBJECTIVE: The objective of this study was to use 2 registries to compare the outcomes of patients receiving adjuvant radiation or no radiation after definitive surgery for pathologic stage I-III MPM. METHODS: Patients with resected pathologic stage I-III MPM were identified from the Duke University registry (1996-2016) and National Cancer Database (NCDB) (2004-2015). The primary outcome was overall survival. Propensity score-matched and landmark subgroup analyses were performed. RESULTS: A total of 212 institutional and 1615 NCDB patients met criteria. In both cohorts, patients who underwent radiation were more likely to have margin-negative resection and more advanced pathologic stage. At a landmark time of 4.4 and 4.7 months from surgery, Duke [hazard ratio (HR) 1.14; 95% confidence interval (CI) 0.62-2.11] and NCDB patients (HR 0.97; 95% CI 0.81-1.17) who received adjuvant radiation did not experience improved survival compared to those who did not receive radiation in multivariable analysis. Duke patients who received radiation had similar incidence of recurrence and time to both overall recurrence and ipsilateral recurrence (HR 0.87; 95% CI 0.43-1.77) compared to those who did not. Duke patients experienced 100 grade 1/2, 21 grade 3/4, and one grade 5 toxicity events during radiation. CONCLUSIONS: In this dual registry analysis of patients with resected stage I-III MPM, the receipt of adjuvant hemithoracic radiation was not associated with improved survival compared to no radiation.

Duke Scholars

Author David Harold Harpole Jr. Surgery, Cardiovascular and Thoracic Surgery

Author Betty Caroline Tong Surgery, Cardiovascular and Thoracic Surgery

Author Oliver Jawitz

Author Kristen Rhodin

Author Thomas Anthony D'Amico Surgery, Cardiovascular and Thoracic Surgery

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Published In

Ann Surg

DOI

10.1097/SLA.0000000000004976

EISSN

1528-1140

Publication Date

March 1, 2023

Volume

277

Issue

Start / End Page

e648 / e656

Location

United States

Related Subject Headings

Surgery
Registries
Pleural Neoplasms
Mesothelioma, Malignant
Mesothelioma
Lung Neoplasms
Humans
3202 Clinical sciences
11 Medical and Health Sciences

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APA

Chicago

ICMJE

MLA

NLM

Raman, V., Voigt, S. L., Jawitz, O. K., Farrow, N. E., Rhodin, K. E., Yang, C.-F., … Harpole, D. H. (2023). The Impact of Adjuvant Hemithoracic Radiation on Outcomes in Patients With Stage I-III Malignant Pleural Mesothelioma: A Dual Registry Analysis. Ann Surg, 277(3), e648–e656. https://doi.org/10.1097/SLA.0000000000004976

Raman, Vignesh, Soraya L. Voigt, Oliver K. Jawitz, Norma E. Farrow, Kristen E. Rhodin, Chi-Fu Jeffrey Yang, Betty C. Tong, Thomas A. D’Amico, and David H. Harpole. “The Impact of Adjuvant Hemithoracic Radiation on Outcomes in Patients With Stage I-III Malignant Pleural Mesothelioma: A Dual Registry Analysis.” Ann Surg 277, no. 3 (March 1, 2023): e648–56. https://doi.org/10.1097/SLA.0000000000004976.

Raman V, Voigt SL, Jawitz OK, Farrow NE, Rhodin KE, Yang C-FJ, et al. The Impact of Adjuvant Hemithoracic Radiation on Outcomes in Patients With Stage I-III Malignant Pleural Mesothelioma: A Dual Registry Analysis. Ann Surg. 2023 Mar 1;277(3):e648–56.

Raman, Vignesh, et al. “The Impact of Adjuvant Hemithoracic Radiation on Outcomes in Patients With Stage I-III Malignant Pleural Mesothelioma: A Dual Registry Analysis.” Ann Surg, vol. 277, no. 3, Mar. 2023, pp. e648–56. Pubmed, doi:10.1097/SLA.0000000000004976.

Raman V, Voigt SL, Jawitz OK, Farrow NE, Rhodin KE, Yang C-FJ, Tong BC, D’Amico TA, Harpole DH. The Impact of Adjuvant Hemithoracic Radiation on Outcomes in Patients With Stage I-III Malignant Pleural Mesothelioma: A Dual Registry Analysis. Ann Surg. 2023 Mar 1;277(3):e648–e656.