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Relapse Patterns and Tailored Treatment Strategies for Malignant Pleural Mesothelioma Recurrence after Multimodality Therapy
Open AccessBrief Report

Surgical Diagnosis of Malignant Pleural Mesothelioma: 20 Years’ Experience at a High-Volume Referral Center

1
Thoracic Surgery Department, Cochin Hospital, APHP.CUP, Paris University, 75014 Paris, France
2
Università Cattolica del Sacro Cuore, 00168 Rome, Italy
3
Thoracic Surgery Department, Policlinico Gemelli, 00168 Roma, Italy
4
Pathology Department, Cochin Hospital, APHP.CUP, Paris University, 75014 Paris, France
*
Author to whom correspondence should be addressed.
The authors contributed equally to this work.
Academic Editor: Maria Lina Tornesello
J. Clin. Med. 2021, 10(9), 1973; https://doi.org/10.3390/jcm10091973
Received: 25 March 2021 / Revised: 19 April 2021 / Accepted: 29 April 2021 / Published: 4 May 2021
Despite advances, malignant pleural mesothelioma (MPM) remains a challenging disease in terms of diagnosis, treatment, and overall management. Herein, we analyzed, in a large-scale single-center cohort, the characteristics and perioperative course of patients undergoing surgical diagnosis of MPM. We identified a total of 514 consecutive patients, 71.4% male and 28.6% female, with mean age 71.3 +/− 13.6 years. Most exhibited pleural, respiratory, or general symptoms and American Society of Anesthesiologists (ASA) score was ≥3 in 68.3% of cases. Thoracoscopy was the most frequent approach (92.0%) and short open thoracotomy was performed in the remaining patients. Pleurodesis was simultaneously performed in 74.3% of cases. Diagnostic failure led to redo surgery in 3.7% of patients. Non-epithelioid histology was found in 19.5% of MPMs and was significantly more frequent in right-sided MPM (p = 0.04), and in patients without history of cancer (p = 0.03), or pleural nodules at thoracoscopy (p = 0.01). Minor only or major complications occurred in respectively 7.8% and 3.6% of cases. They were more frequent in patients ≥ 70 years (p = 0.05) and Performance Status > 2 (p = 0.05). The mean hospital stay was 7.5 days. The 30-day and 90-day early mortality rates were 2.3% and 6.4%, respectively. Surgical diagnosis of MPM is a reliable procedure but is associated with significant morbidity and hospital-stay duration. View Full-Text
Keywords: mesothelioma; thoracoscopy; pleurodesis; morbidity; diagnosis mesothelioma; thoracoscopy; pleurodesis; morbidity; diagnosis
MDPI and ACS Style

Iaffaldano, A.; Charrier, T.; Lococo, F.; Damotte, D.; Bobbio, A.; Alifano, M.; Fournel, L. Surgical Diagnosis of Malignant Pleural Mesothelioma: 20 Years’ Experience at a High-Volume Referral Center. J. Clin. Med. 2021, 10, 1973. https://doi.org/10.3390/jcm10091973

AMA Style

Iaffaldano A, Charrier T, Lococo F, Damotte D, Bobbio A, Alifano M, Fournel L. Surgical Diagnosis of Malignant Pleural Mesothelioma: 20 Years’ Experience at a High-Volume Referral Center. Journal of Clinical Medicine. 2021; 10(9):1973. https://doi.org/10.3390/jcm10091973

Chicago/Turabian Style

Iaffaldano, Amedeo; Charrier, Thomas; Lococo, Filippo; Damotte, Diane; Bobbio, Antonio; Alifano, Marco; Fournel, Ludovic. 2021. "Surgical Diagnosis of Malignant Pleural Mesothelioma: 20 Years’ Experience at a High-Volume Referral Center" J. Clin. Med. 10, no. 9: 1973. https://doi.org/10.3390/jcm10091973

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