Surgical Management of Malignant Pleural Mesothelioma: Impact of Surgery on Survival and Quality of Life—Relation to Chemotherapy, Radiotherapy, and Alternative Therapies

Introduction. Malignant pleural mesothelioma (MPM) is an aggressive cancer arising from pleural mesothelium. Surgery aims to either cure the disease or control the symptoms. Two surgical procedures exist: extrapleural pneumonectomy (EPP) and pleurectomy/decortication (P/D). In this systematic review we assess current evidence on safety and efficacy of surgery. Methods. Five electronic databases were reviewed from January 1990 to January 2013. Studies were selected according to a predefined protocol. Primary endpoint was overall survival. Secondary endpoints included quality of life, disease-free survival, disease recurrence, morbidity, and length of hospital stay. Results. Sixteen studies were included. Median survival ranged from 8.1 to 32 months for P/D and from 6.9 to 46.9 months for EPP. Perioperative mortality was 0%–9.8% and 3.2%–12.5%, respectively. Perioperative morbidity was 5.9%–55% for P/D and 10%–82.6% for EPP. Average length of stay was 7 days for P/D and 9 days for EPP. Conclusion. Current evidence cannot definitively answer which procedure (EPP or P/D) is more beneficial in terms of survival and operative risks. This systematic review suggests that surgery in the context of trimodality therapy offers acceptable perioperative outcomes and long-term survival. Centres specialising in MPM management have better results.

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Systematic review of quality of life following pleurectomy decortication and extrapleural pneumonectomy for malignant pleural mesothelioma

BMC Cancer ◽

10.1186/s12885-018-5064-4 ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 6

Author(s):

Rebecca M. Schwartz ◽

Wil Lieberman-Cribbin ◽

Andrea Wolf ◽

Raja M. Flores ◽

Emanuela Taioli

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Malignant Pleural Mesothelioma ◽

Extrapleural Pneumonectomy ◽

Pleural Mesothelioma

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The Prevalence of Sarcopenia and Its Impact on Clinical Outcomes in Lumbar Degenerative Spine Disease—A Systematic Review and Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm10040773 ◽

2021 ◽

Vol 10 (4) ◽

pp. 773

Author(s):

Wei-Ting Wu ◽

Tsung-Min Lee ◽

Der-Sheng Han ◽

Ke-Vin Chang

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Clinical Outcomes ◽

Meta Analysis ◽

Clinical Manifestations ◽

Current Evidence ◽

Degenerative Spine ◽

Degenerative Spine Disease ◽

Spine Disease

The association of sarcopenia with poor clinical outcomes has been identified in various medical conditions, although there is a lack of quantitative analysis to validate the influence of sarcopenia on patients with lumbar degenerative spine disease (LDSD) from the available literature. Therefore, this systematic review and meta-analysis aimed to summarize the prevalence of sarcopenia in patients with LDSD and examine its impact on clinical outcomes. The electronic databases (PubMed and Embase) were systematically searched from inception through December 2020 for clinical studies investigating the association of sarcopenia with clinical outcomes in patients with LDSD. A random-effects model meta-analysis was carried out for data synthesis. This meta-analysis included 14 studies, comprising 1953 participants. The overall prevalence of sarcopenia among patients with LDSD was 24.8% (95% confidence interval [CI], 17.3%–34.3%). The relative risk of sarcopenia was not significantly increased in patients with LDSD compared with controls (risk ratio, 1.605; 95% CI, 0.321–8.022). The patients with sarcopenia did not experience an increase in low back and leg pain. However, lower quality of life (SMD, −0.627; 95% CI, −0.844–−0.410) were identified postoperatively. Sarcopenia did not lead to an elevated rate of complications after lumbar surgeries. Sarcopenia accounts for approximately one-quarter of the population with LDSD. The clinical manifestations are less influenced by sarcopenia, whereas sarcopenia is associated with poorer quality of life after lumbar surgeries. The current evidence is still insufficient to support sarcopenia as a predictor of postoperative complications.

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Evaluation of quality of life in survivors with malignant pleural mesothelioma in Japan

Annals of Oncology ◽

10.1093/annonc/mdx389.007 ◽

2017 ◽

Vol 28 ◽

pp. v571

Author(s):

I. Oze ◽

Y. Nagamatsu ◽

K. Aoe ◽

K. Hotta ◽

K. Kato ◽

...

Keyword(s):

Quality Of Life ◽

Malignant Pleural Mesothelioma ◽

Pleural Mesothelioma

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Early specialist palliative care on quality of life for malignant pleural mesothelioma: a randomised controlled trial

Thorax ◽

10.1136/thoraxjnl-2018-212380 ◽

2019 ◽

Vol 74 (4) ◽

pp. 354-361 ◽

Cited By ~ 7

Author(s):

Fraser Brims ◽

Samal Gunatilake ◽

Iain Lawrie ◽

Laura Marshall ◽

Carole Fogg ◽

...

Keyword(s):

Quality Of Life ◽

Palliative Care ◽

Malignant Pleural Mesothelioma ◽

Controlled Trial ◽

Mean Difference ◽

Pleural Mesothelioma ◽

Life Questionnaire ◽

Specialist Palliative Care ◽

European Organization

PurposeMalignant pleural mesothelioma (MPM) has a high symptom burden and poor survival. Evidence from other cancer types suggests some benefit in health-related quality of life (HRQoL) with early specialist palliative care (SPC) integrated with oncological services, but the certainty of evidence is low.MethodsWe performed a multicentre, randomised, parallel group controlled trial comparing early referral to SPC versus standard care across 19 hospital sites in the UK and one large site in Western Australia. Participants had newly diagnosed MPM; main carers were additionally recruited. Intervention: review by SPC within 3 weeks of allocation and every 4 weeks throughout the study. HRQoL was assessed at baseline and every 4 weeks with the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30. Primary outcome: change in EORTC C30 Global Health Status 12 weeks after randomisation.ResultsBetween April 2014 and October 2016, 174 participants were randomised. There was no significant between group difference in HRQoL score at 12 weeks (mean difference 1.8 (95% CI −4.9 to 8.5; p=0.59)). HRQoL did not differ at 24 weeks (mean difference −2.0 (95% CI −8.6 to 4.6; p=0.54)). There was no difference in depression/anxiety scores at 12 weeks or 24 weeks. In carers, there was no difference in HRQoL or mood at 12 weeks or 24 weeks, although there was a consistent preference for care, favouring the intervention arm.ConclusionThere is no role for routine referral to SPC soon after diagnosis of MPM for patients who are cared for in centres with good access to SPC when required.Trial registration numberISRCTN18955704.

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The effect of exercise therapy combined with psychological therapy on physical activity and quality of life in patients with painful diabetic neuropathy: a systematic review

Scandinavian Journal of Pain ◽

10.1515/sjpain-2019-0001 ◽

2019 ◽

Vol 19 (3) ◽

pp. 433-439 ◽

Cited By ~ 5

Author(s):

Charlotte C.M. van Laake-Geelen ◽

Rob J.E.M. Smeets ◽

Suzan P.A.B. Quadflieg ◽

Jos Kleijnen ◽

Jeanine A. Verbunt

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Systematic Review ◽

Diabetic Neuropathy ◽

Exercise Therapy ◽

Treatment Modalities ◽

Current Evidence ◽

Psychological Interventions ◽

Painful Diabetic Neuropathy

Abstract Background and aims Approximately 25% of patients with diabetes mellitus type 2 (DMII) develop painful diabetic neuropathy (PDN). PDN is known to affect both mental and physical wellbeing, resulting in anxiety, depression, low quality of life and physical disability. Pharmacological treatment of PDN aims at pain relief and is often ineffective and/or has many side effects. Rehabilitation treatment modalities that are designed to help the patient deal with PDN related complaints, are mostly focussed on either physical (e.g. exercise therapy) or psychological aspects (e.g. cognitive behavioural therapy, CBT). There is emerging evidence that PDN can be approached from a biopsychosocial perspective, in which physical and psychosocial aspects are integrated. From this biopsychosocial approach it is plausible that integrated treatment modalities such as acceptance commitment therapy (ACT) or exposure in vivo (EXP) could be effective in patients with PDN. The objective of this review was to provide an overview of the current evidence on the effects of rehabilitation treatments that combine exercise therapies with psychological therapies in order to improve physical activity (PA) and quality of life (QoL) in patients with PDN. Methods Systematic review of the current literature. EMBASE, MEDLINE, Medline In-Process citations and e-Pubs ahead-of-print, Pedro, Web of Science, PsycINFO, CENTRAL, PubMed and Google Scholar were searched. All studies on interventions combining exercise therapy with psychological interventions in patients with PDN, aged >18 years, were included. Outcome measures were PA, QoL. Results The search resulted in 1603 records after removing duplicates. After screening on titles and abstracts, 100 records remained. From these, not one study reported on interventions that combined exercise therapy with psychological interventions. Through a secondary hand search, a total of three reviews were identified that described a total of five studies regarding either physical or psychological interventions in patients with PDN. These studies reported moderate effects of (1) mindfulness meditation on QoL, (2) CBT on pain severity, (3) mindfulness-based stress reduction intervention on function, health-related QoL, pain catastrophizing and depression, (4) aerobic exercise on QoL and (5) Tai Chi on glucose control, balance, neuropathic symptoms, and some dimensions of QoL in patients with PDN. All studies were of a moderate quality, and results should be interpreted with caution. Conclusions Based on increasing knowledge in the domain of chronic pain, it could be assumed that integrated rehabilitation treatments for patients with PDN are beneficial. There is no literature to support this and more research should be done on integrated biopsychosocial interventions in patients with PDN. Implications This empty review highlights the importance that more research should be done on integrated biopsychosocial interventions in patients with PDN. Currently, our research group is performing a study on the effects of EXP treatment in patients with PDN.

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Phase II Study of Vinorelbine in Patients With Malignant Pleural Mesothelioma

Journal of Clinical Oncology ◽

10.1200/jco.2000.18.23.3912 ◽

2000 ◽

Vol 18 (23) ◽

pp. 3912-3917 ◽

Cited By ~ 149

Author(s):

Jeremy P. C. Steele ◽

Jonathan Shamash ◽

Marie T. Evans ◽

Nicole H. Gower ◽

Marc D. Tischkowitz ◽

...

Keyword(s):

Quality Of Life ◽

Malignant Pleural Mesothelioma ◽

Stage Iv ◽

Staging System ◽

Median Number ◽

Response To Treatment ◽

Pleural Mesothelioma ◽

Stage Iv Disease ◽

New Guidelines

PURPOSE: To evaluate the response rate and impact on quality of life of vinorelbine given as cycles of 30 mg/m2 weekly for 6 weeks to patients with malignant pleural mesothelioma. PATIENTS AND METHODS: Twenty-nine patients with histologically proven malignant pleural mesothelioma were enrolled (26 male patients and three female patients; median age, 58 years [range, 29 to 77 years]). Seventeen patients had epithelioid tumors, two had sarcomatoid tumors, and 10 had biphasic tumors. The International Mesothelioma Interest Group staging system was used: one patient had stage Ib disease, 10 had stage II disease, eight had stage III disease, and 10 had stage IV disease. Patients were treated with weekly injections of vinorelbine 30 mg/m2. A cycle consisted of six weekly injections. The new guidelines to evaluate the response to treatment in solid tumors were used. Responses were measured by spiral computed tomography scan. RESULTS: All twenty-nine patients had measurable disease and were assessed for response. There were seven partial responses (24% [95% confidence interval, 10% to 44%]), 16 patients had stable disease (55%), and six patients had disease progression on therapy (21%). The median number of vinorelbine injections was 12 (range, 2 to 30). Quality-of-life analyses showed a benefit for vinorelbine therapy. CONCLUSION: Vinorelbine shows promise in the palliation of patients with malignant pleural mesothelioma. The relatively low toxicity of the drug suggests that trials of vinorelbine in combination with other agents should be feasible.

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Nutrition and Breast Cancer: A Literature Review on Prevention, Treatment and Recurrence

Nutrients ◽

10.3390/nu11071514 ◽

2019 ◽

Vol 11 (7) ◽

pp. 1514 ◽

Cited By ~ 27

Author(s):

Paola De Cicco ◽

Maria Valeria Catani ◽

Valeria Gasperi ◽

Matteo Sibilano ◽

Maria Quaglietta ◽

...

Keyword(s):

Breast Cancer ◽

Quality Of Life ◽

Survival Data ◽

Saturated Fatty Acids ◽

Nutritional Intervention ◽

Dietary Factors ◽

Current Evidence ◽

Drug Induced ◽

Term Survival

Breast cancer (BC) is the second most common cancer worldwide and the most commonly occurring malignancy in women. There is growing evidence that lifestyle factors, including diet, body weight and physical activity, may be associated with higher BC risk. However, the effect of dietary factors on BC recurrence and mortality is not clearly understood. Here, we provide an overview of the current evidence obtained from the PubMed databases in the last decade, assessing dietary patterns, as well as the consumption of specific food-stuffs/food-nutrients, in relation to BC incidence, recurrence and survival. Data from the published literature suggest that a healthy dietary pattern characterized by high intake of unrefined cereals, vegetables, fruit, nuts and olive oil, and a moderate/low consumption of saturated fatty acids and red meat, might improve overall survival after diagnosis of BC. BC patients undergoing chemotherapy and/or radiotherapy experience a variety of symptoms that worsen patient quality of life. Studies investigating nutritional interventions during BC treatment have shown that nutritional counselling and supplementation with some dietary constituents, such as EPA and/or DHA, might be useful in limiting drug-induced side effects, as well as in enhancing therapeutic efficacy. Therefore, nutritional intervention in BC patients may be considered an integral part of the multimodal therapeutic approach. However, further research utilizing dietary interventions in large clinical trials is required to definitively establish effective interventions in these patients, to improve long-term survival and quality of life.

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