Independent lung ventilation using a piston-driven anesthesia machine to ventilate the affected lung during resection of the visceral pleura for malignant pleural mesothelioma: A case series

2021 ◽  
Vol 75 ◽  
pp. 110456
Author(s):  
Tatsuya Kida ◽  
Teisei Kobashi ◽  
Tomohide Takei ◽  
Takao Morohoshi ◽  
Masakazu Sumitomo
Keyword(s):  
Malignant Pleural Mesothelioma ◽  
Case Series ◽  
Lung Ventilation ◽  
Anesthesia Machine ◽  
Pleural Mesothelioma ◽  
Visceral Pleura ◽  
Independent Lung Ventilation

scholarly journals A review of malignant pleural mesothelioma in a large North East UK pleural centre

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Declan C. Murphy ◽  
Alexander Mount ◽  
Fiona Starkie ◽  
Leah Taylor ◽  
Avinash Aujayeb
Keyword(s):  
Malignant Pleural Mesothelioma ◽  
Survival Rates ◽  
Case Series ◽  
Pleural Mesothelioma ◽  
Retrospective Case ◽  
Pleural Thickening ◽  
North East ◽  
Total Cohort ◽  
Anti Cancer ◽  
One Year

AbstractObjectivesThe National Mesothelioma Audit 2020 showed Northumbria to have low rates of histopathological confirmation, treatment and one-year survival rates for malignant pleural mesothelioma (MPM). We hypothesized that an internal analysis over a 10-year period provides valuable insights into presentation, diagnosis, treatment and outcomes.MethodsA single-centre retrospective case series of all confirmed MPM patients between 1 January 2009 and 31 December 2019 was performed. Demographics, clinical, radiological and histopathological characteristics and outcomes were collected. Statistical analysis was performed using SPSS V26.0.ResultsA total of 247 patients had MPM. About 86% were male, mean age 75.7 years. Dyspnoea (77.4%) and chest pain (38.5%) were commonest symptoms. 64.9 and 71.4% had pleural thickening and effusion, respectively. About 86.8% had at least one attempt to obtain a tissue biopsy, but histopathological confirmation in only 108 (43.7%). About 66.3% with PS 0 and 1 (62.7% of total cohort) had at least one anti-cancer therapy. Death within 12 months was associated with disease progression within 6 months (p≤0.001). Chemotherapy (p≤0.001) and epithelioid histological subtype (p=0.01) were protective.ConclusionsThis study confirms known epidemiology of MPM, demonstrates variability in practices and highlights how some NMA recommendations are not met. This provides the incentive for a regional mesothelioma multi-disciplinary meeting.

scholarly journals Pathological evaluation of the visceral pleura in the radical pleurectomy/decortication for malignant pleural mesothelioma patients

2019 ◽  
Vol 11 (3) ◽  
pp. 717-723 ◽  
Author(s):  
Masashi Kobayashi ◽  
Hironori Ishibashi ◽  
Chihiro Takasaki ◽  
Sachiko Imai ◽  
Susumu Kirimura ◽  
...  
Keyword(s):  
Malignant Pleural Mesothelioma ◽  
Pleural Mesothelioma ◽  
Visceral Pleura ◽  
Pathological Evaluation

On the diagnosis of malignant pleural mesothelioma: A necropsy-based study of 171 cases (1997–2016)

2018 ◽  
Vol 105 (4) ◽  
pp. 304-311 ◽  
Author(s):  
Pietro Gino Barbieri ◽  
Dario Mirabelli ◽  
Corrado Magnani ◽  
Alessandro Brollo
Keyword(s):  
Malignant Pleural Mesothelioma ◽  
Case Series ◽  
Pleural Mesothelioma ◽  
Cytologic Examination ◽  
Pleural Plaques ◽  
Radiologic Imaging ◽  
High Positive Predictive Value ◽  
Low Sensitivity ◽  
Clinical Records ◽  
Shipyard Workers

Background:Malignant pleural mesothelioma (MPM) diagnosis is known to be difficult. We report on the diagnostic elements available in life in an MPM necropsy case series and describe the frequency of non-neoplastic asbestos-related diseases as biological exposure indices.Methods:We reviewed pathologic and clinical records of an unselected series of autopsies (1977–2016) in patients with MPM employed in the Monfalcone shipyards or living with shipyard workers. We assessed the consistency with autopsy results of diagnoses based on, respectively, radiologic, cytologic, and histologic findings, with and without immunophenotyping.Results:Data on 171 cases were available: for 169, autopsy confirmed the MPM diagnosis. In life, 119 cases had histologic confirmation of diagnosis, whereas 7 were negative; all cases without immunophenotypization were autoptic MPMs. Cytology alone had been positive in 18 autoptic MPM cases, negative in 14. Radiologic imaging alone had been positive in another 16, negative in 11. In the 2 cases not confirmed at autopsy, MPM had been suspected by chest computed tomography only. Bilateral pleural plaques were found in 144 and histologic evidence of asbestosis in 62 cases.Conclusions:Autopsies confirmed 169/171 cases, including cases that would not be considered as certain based on diagnosis in life. Radiologic imaging, cytologic examination of pleural effusions, or both combined had low sensitivity but high positive predictive value: when they are positive, proceeding to thoracoscopy should be justified. MPM has been correctly diagnosed even without immunohistochemistry. The prevalence of pleural plaques and asbestosis was high due to severity of asbestos exposures in these cases.

Treatment outcomes in malignant pleural mesothelioma: A single center experience of systemic therapies and biomarkers.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e20070-e20070
Author(s):  
Adithya Balasubramanian ◽  
Adrian Pick ◽  
Beena Kumar ◽  
Zdenka Prodanovic ◽  
Prashant Joshi ◽  
...  
Keyword(s):  
Malignant Pleural Mesothelioma ◽  
Survival Data ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Asbestos Exposure ◽  
Case Series ◽  
Stage Iv ◽  
Pleural Mesothelioma ◽  
Retrospective Audit

e20070 Background: Malignant Pleural Mesothelioma (MPM) is a rare but fatal disease related to asbestos exposure, with historic survival in the order of 9 to 17 months. Chemotherapy is associated with only a modest benefit. The advent of immunotherapy has heralded significantly improved outcomes using checkpoint inhibitors in an as yet ill-defined cohort. We aim to identify predictive and prognostic biomarkers in a series of patients (pts) with MPM and describe survival data. Methods: A retrospective audit was undertaken of pts with MPM diagnosed between 2013 and 2017 at a single tertiary centre in Melbourne, Australia (Monash Health). Data relating to patient outcomes and clinicopathological features were obtained through medical reports. Further immunostains are being performed on archived tissue for PDL-1 status. Results: 65 pts were identified, of whom 52 (80.0%) were male. Median age was 73 years (range 44-90). 52 pts were noted to be ECOG 0-1. 42 pts (64.6%) were noted to have suspected asbestos exposure. Epithelioid MPM was the most common subtype, noted in 41 pts (63.1%) (table 1). 8 pts (12.3%) presented with stage IV disease. 16 pts (24.6%) received checkpoint inhibitor therapy, with 10 (63 %) in the second/third line setting. Median overall survival (OS) was 19.8 months (95% CI 13.3-26.3) in the whole cohort.Patient characteristics associated with poor OS were: presence of weight loss (P = 0.001), chest pain (p = 0.08) and ECOG 2 (p = 0.04). Pts with sarcomatoid histology who received immune checkpoint inhibitors in any line of treatment had significantly prolonged OS compared to other histologies. 3-year survival was 80% in this group while median OS was not reached (p = 0.04). This difference was not seen with other histologies. Conclusions: The evolving landscape of treatment in MPM appears to show promise in improving OS. In this unselected case series, our data is consistent with historic controls in terms of survival and prognostic factors. The finding of significantly improved survival with immune checkpoint inhibitors in the sarcomatoid histology is exciting and warrants further exploration. Further data on PDL1 status will be presented.

scholarly journals Extended pleurectomy/decortication for malignant pleural mesothelioma in a young female with no obvious macroscopic lesions in the visceral pleura

2016 ◽  
Vol 30 (5) ◽  
pp. 555-560
Author(s):  
Yuki Nakajima ◽  
Hirohiko Akiyama ◽  
Hiroyasu Kinoshita ◽  
Yoshihito Iijima ◽  
Takako Matsumoto ◽  
...  
Keyword(s):  
Malignant Pleural Mesothelioma ◽  
Young Female ◽  
Pleural Mesothelioma ◽  
Visceral Pleura

scholarly journals Diagnostic Challenges in Epithelioid Pleural Mesothelioma: Case Series with Support from Electron Microscopy

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 841
Author(s):  
Francesco Fortarezza ◽  
Mila Della Barbera ◽  
Federica Pezzuto ◽  
Francesca Lunardi ◽  
Eleonora Faccioli ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Malignant Pleural Mesothelioma ◽  
Rare Variants ◽  
Case Series ◽  
Morphological Characteristics ◽  
Pleural Mesothelioma ◽  
Ultrastructural Examination ◽  
Specific Diagnosis ◽  
Final Interpretation ◽  
Definition Of

The histological diagnosis of pleural epithelioid mesothelioma can be difficult in the case of rare variants or in the definition of neoplasm origin in patients with previous or concomitant tumours. Currently, several immunohistochemical reactions are available in the surgical pathologist’s armamentarium that allow us to obtain a more sensitive and specific diagnosis of malignant pleural mesothelioma. However, in some cases, the final interpretation remains inconclusive. Historically, ultrastructural examination has represented a useful tool for the definition of the mesothelial nature of neoplastic cells due to their peculiar morphological characteristics. The recent international guidelines for pathological diagnosis of pleural mesothelioma suggest the use of electron microscopy when the immunohistochemical reactions are equivocal or when further support of a diagnosis of mesothelioma is needed. This paper presents three cases of pleural epithelioid mesothelioma whose diagnoses were finally supported by ultrastructural examination.

scholarly journals A Trimodality, Four-Step Treatment including Chemotherapy, Pleurectomy/Decortication and Radiotherapy in Early-Stage Malignant Pleural Mesothelioma: A Single-Institution Retrospective Case Series Study

Cancers ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 142
Author(s):  
Giovanni Vicidomini ◽  
Carminia Maria Della Corte ◽  
Antonio Noro ◽  
Raimondo Di Liello ◽  
Salvatore Cappabianca ◽  
...  
Keyword(s):  
Malignant Pleural Mesothelioma ◽  
Early Stage ◽  
Objective Response ◽  
Case Series ◽  
Cardiac Massage ◽  
Pleural Mesothelioma ◽  
Retrospective Case ◽  
Intraoperative Complication ◽  
Retrospective Case Series ◽  
Case Series Study

Background: Multimodality treatment is considered the best treatment strategy for malignant pleural mesothelioma (MPM). However, the ideal combination of them is still a matter of controversy. Here, we report a case series of MPM treated with a trimodality approach: induction chemotherapy (CT), pleurectomy/decortication (P/D), postoperative radiotherapy (RT) and post-operative CT. Methods: A retrospective case series of 17 MPM patients treated between 2013 and 2020 is presented. Patients had epithelial or mixed MPM diagnosed by video-assisted thoracoscopy and pathologic IMIG stage I or II disease. Treatment details and radiological data were collected. Induction therapy consisted of combination of cisplatin and pemetrexed, every 21 days for two cycles. P/D was performed 4–6 weeks after induction CT, post-operative RT 3–6 weeks after surgery, while post-operative CT was given 4–6 weeks after RT, with the same schedule of induction. Results: All patients showed objective response or stability of disease at the restaging following induction CT and underwent surgery by posterolateral thoracotomy. There were two cases of cardiac arrest as major intraoperative complication, both resolved by manual cardiac massage. Minor complications included one hemidiaphragm elevation, 1 anemia requiring blood transfusion, one wound infection, and two persistent air leaks. Median overall survival was 32.1 months, median progression free survival was 23.7 months. Conclusions: These results suggest the feasibility of these trimodality treatment scheme for early stage MPM patients. Larger series and long-term prospective studies are needed to confirm the validity of this strategy.

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