Imperial College London
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Professor Thanos Athanasiou MD PhD MBA FECTS FRCS

Faculty of Medicine, Department of Surgery & Cancer

Professor of Cardiovascular Sciences
 
 
 
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Contact

 

t.athanasiou

 
 
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Location

 

1022Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Magouliotis:2022:10.1007/s13304-022-01369-4,
author = {Magouliotis, DE and Zotos, P-A and Rad, AA and Koukousaki, D and Vasilaki, V and Portesi, I and Spiliopoulos, K and Athanasiou, T},
doi = {10.1007/s13304-022-01369-4},
journal = {Updates Surg},
pages = {1827--1837},
title = {Meta-analysis of survival after extrapleural pneumonectomy (EPP) versus pleurectomy/decortication (P/D) for malignant pleural mesothelioma in the context of macroscopic complete resection (MCR).},
url = {http://dx.doi.org/10.1007/s13304-022-01369-4},
volume = {74},
year = {2022}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - OBJECTIVE: We reviewed the available literature on patients with MPM undergoing either extrapleural pneumonectomy (EPP) or pleurectomy/decortication (P/D). METHODS: Original research studies that evaluated long-term outcomes of P/D versus EPP were identified, from January 1980 to February 2022. The 30-days and 90-day mortality, along with the 1-, 2-, 3-, 5-year survival, the median overall survival, the macroscopic complete resection (MCR) rate, and the complications were calculated according to both a fixed and a random effect model. The Q and I2 statistic were used to test for heterogeneity among the studies. Sensitivity analysis was performed including only studies that incorporated the MCR concept. RESULTS: Eighteen studies were included, incorporating a total of 4,852 patients treated with EPP and P/D. The 30-day mortality was significantly higher in the EPP group (OR: 2.79 [95% CI 1.30, 6.01]; p = 0.009). The median overall survival was higher in the P/D group (WMD:-4.55 [-6.05, -3.04]; p < 0.001). No differences were found regarding the 90-day mortality, MCR rate, and the 1-, 2-,3-, 5-year survival between the EPP and P/D groups. These findings were validated by the sensitivity analysis. The incidence of atrial fibrillation, hemorrhage, pulmonary embolism, air leak, and reoperation was significantly increased in the EPP group (p < 0.05). CONCLUSIONS: The present meta-analysis indicates that P/D is associated with enhanced outcomes regarding 30-day mortality, median overall survival, and complications. The P/D approach should be preferred when technically feasible. However, the procedure of choice should be decided based on the goal of MCR in the safest approach for the patient.
AU  - Magouliotis,DE
AU  - Zotos,P-A
AU  - Rad,AA
AU  - Koukousaki,D
AU  - Vasilaki,V
AU  - Portesi,I
AU  - Spiliopoulos,K
AU  - Athanasiou,T
DO  - 10.1007/s13304-022-01369-4
EP  - 1837
PY  - 2022///
SP  - 1827
TI  - Meta-analysis of survival after extrapleural pneumonectomy (EPP) versus pleurectomy/decortication (P/D) for malignant pleural mesothelioma in the context of macroscopic complete resection (MCR).
T2  - Updates Surg
UR  - http://dx.doi.org/10.1007/s13304-022-01369-4
UR  - https://www.ncbi.nlm.nih.gov/pubmed/36057027
VL  - 74
ER  -
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