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Query: UMLS:C0729233 (Thoracic)
 6,478 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In this article, we explain the current trimodality approach used to treat malignant pleural mesothelioma. Our current approach employs extrapleural pneumonectomy as the cytoreductive procedure followed by combination chemoradiotherapy. Trimodality therapy was performed at the Dana-Farber Cancer Institute/Brigham and Women's Hospital Thoracic Oncology Program. From 1980 to 1995, we prospectively followed up a series of 120 patients with confirmed malignant pleural mesothelioma who underwent trimodality therapy. Two- and 5-year survival rates for the entire cohort were 45% and 22%, respectively. Survival rates were 65% and 27%, respectively, at 2 and 5 years for patients with epithelial histology. Patients with sarcomatous or mixed histology had the poorest prognosis, with 2- and 5-year survival rates of 20% and 0%, respectively. For patients with epithelial tumors and negative nodes, survival at 2 and 5 years was 74% and 39%, respectively. Extrapleural pneumonectomy in the context of trimodality therapy is a potential surgical option for a selected group of patients with malignant pleural mesothelioma.
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PMID:Multimodality management of malignant pleural mesothelioma. 943 92

Innovative therapeutic agents and strategies are being investigated to improve survival with this lethal disease. New chemotherapy agents, including gemcitabine (Eli Lilly and Company; Indianapolis, Indiana) and pemtrexed (Eli Lilly and Company) show promise against mesothelioma. Kaiser has reported using novel therapies, such as cytokines and suicide gene therapy, to target mesothelioma. Pass et al , Moskal et al , Schouwink et al , and Friedberg et al have applied photodynamic therapy to the hemithorax after surgical resection. Because recurrence of mesothelioma after surgical resections tends be locoregional rather than distant , strategies to improve local control may be beneficial. Several groups, including our Brigham and Women's Hospital Thoracic Surgery Division and Dana Farber Thoracic Oncology Program, are investigating intraoperative intracavitary lavage of hyperthermic chemotherapy immediately after EP (discussed elsewhere in this issue). Although mesothelioma remains a difficult disease to treat, the techniques of surgical resection for mesothelioma have improved dramatically. Currently, EPP can be performed with acceptable morbidity and mortality at experienced centers.
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PMID:Extrapleural pneumonectomy for diffuse malignant pleural mesothelioma: techniques and complications. 1555 59