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

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.

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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 ◽

10.3390/cancers14010142 ◽

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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Hitting the Bull’s-Eye: Mesothelin’s Role as a Biomarker and Therapeutic Target for Malignant Pleural Mesothelioma

Cancers ◽

10.3390/cancers13163932 ◽

2021 ◽

Vol 13 (16) ◽

pp. 3932

Author(s):

Dannel Yeo ◽

Laura Castelletti ◽

Nico van Zandwijk ◽

John E. J. Rasko

Keyword(s):

Malignant Pleural Mesothelioma ◽

Treatment Options ◽

Survival Rates ◽

Treatment Strategies ◽

Pleural Mesothelioma ◽

Normal Tissues ◽

Drug Conjugates ◽

Aggressive Cancer ◽

Immunotherapy Target ◽

Bull's Eye

Malignant pleural mesothelioma (MPM) is an aggressive cancer with limited treatment options and poor prognosis. MPM originates from the mesothelial lining of the pleura. Mesothelin (MSLN) is a glycoprotein expressed at low levels in normal tissues and at high levels in MPM. Many other solid cancers overexpress MSLN, and this is associated with worse survival rates. However, this association has not been found in MPM, and the exact biological role of MSLN in MPM requires further exploration. Here, we discuss the current research on the diagnostic and prognostic value of MSLN in MPM patients. Furthermore, MSLN has become an attractive immunotherapy target in MPM, where better treatment strategies are urgently needed. Several MSLN-targeted monoclonal antibodies, antibody–drug conjugates, immunotoxins, cancer vaccines, and cellular therapies have been tested in the clinical setting. The biological rationale underpinning MSLN-targeted immunotherapies and their potential to improve MPM patient outcomes are reviewed.

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Impact of SARS-COV-2 Pandemic on Kidney Cancer Management

Kidney Cancer ◽

10.3233/kca-210112 ◽

2021 ◽

pp. 1-14

Author(s):

Melissa Bersanelli ◽

Camillo Porta

Keyword(s):

Survival Rates ◽

Delayed Diagnosis ◽

Case Series ◽

Cost Benefit ◽

Original Data ◽

Immune Checkpoint Blockade ◽

Retrospective Case ◽

Renal Masses ◽

Term Survival ◽

Cancer Management

Background: The SARS-CoV-2 pandemic still has a huge impact on the management of many chronic diseases such as cancer. Few data are presently available reagarding how the management of renal cell carcinoma (RCC) has changed due to this unprecedented situation. Objective: To discuss the challenges and issues of the diagnosis and treatment of RCC in the COVID-19 era, and to provide recommendations based on the collected literature and our personal experience. Methods: Systematic review of the available Literature regarding the management of RCC during the SARS-CoV-2 pandemic. Results: Our review showed a prevalence of narrative publications, raising the issue of the real relevance of the evidence retrieved. Indeed, the only original data about RCC and COVID-19 found were a small retrospective case series and two surveys, providing either patients’ or physicians’ viewpoints. Conclusions: The expected delayed diagnosis of RCC could lead to an increase of advanced/metastatic cases; thus, proper therapeutic choices for patients with small renal masses should be carefully evaluated case by case, in order to avoid negative effects on long-term survival rates. The controversial interaction between immune checkpoint blockade and COVID-19 pathogenesis is more hypothetical than evidence-based, and thus immunotherapy should not be denied, whenever appropriate. To avoid treatments which won’t have an impact on patients’ survival, a honest and accurate evaluation of the cost/benefit ratio of each treatment option should be always performed. Finally, SARS-CoV-2 swab positivity should not prevent the continuation of ongoing active treatments in asymptomatic cases, or or after symptoms’ resolution.

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One-year Follow-Up Results with Hydrogel Implant in Therapy of Hallux Rigidus: Case Series with 44 Patients

Zeitschrift für Orthopädie und Unfallchirurgie ◽

10.1055/a-1365-9655 ◽

2021 ◽

Author(s):

Christoph Zanzinger ◽

Norbert Harrasser ◽

Oliver Gottschalk ◽

Patrick Dolp ◽

Florian Hinterwimmer ◽

...

Keyword(s):

Learning Algorithm ◽

Case Series ◽

Metatarsophalangeal Joint ◽

Hallux Rigidus ◽

Therapy Failure ◽

Retrospective Case ◽

Aofas Score ◽

Medium Level ◽

One Year

Abstract Background The Cartiva implant (CI) is being increasingly used in the surgical therapy of hallux rigidus. Despite a growing number of studies, numerous questions regarding patient selection remain unanswered. Patients and Methods As part of a retrospective case series with prospective follow-up (average follow-up period: 12 months), a total of 44 patients (male/female = 16/28; mean age at the time of surgery: 55.4 years) with 44 CI were analysed (VAS, EFAS-, AOFAS-score). Using a correlation analysis and a machine learning algorithm, risk factors for therapy failure were investigated. Results The overall survival rate of the CI was 93% at 12 months. The VAS, EFAS and AOFAS scores showed a significant improvement in comparison to the preoperative condition. The mobility of the metatarsophalangeal joint showed no increase. Patients with a medium osteoarthritis grade and a medium level of clinical restraint showed the greatest improvement in relation to their preoperative condition. Conclusion The CI can be seen as an effective therapy for hallux rigidus. Nonetheless, realistic patient expectations must be communicated.

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Lung Ultrasound Patterns and Clinical-Laboratory Correlates during COVID-19 Pneumonia: A Retrospective Study from North East Italy

Journal of Clinical Medicine ◽

10.3390/jcm10061288 ◽

2021 ◽

Vol 10 (6) ◽

pp. 1288

Author(s):

Riccardo Senter ◽

Federico Capone ◽

Stefano Pasqualin ◽

Lorenzo Cerruti ◽

Leonardo Molinari ◽

...

Keyword(s):

Lung Ultrasound ◽

Clinical Laboratory ◽

Imaging Modality ◽

Case Series ◽

Severity Index ◽

Disease Stage ◽

Retrospective Case ◽

North East ◽

High Flow Oxygen ◽

B Lines

Background and Aim. Lung ultrasound (LUS) is a convenient imaging modality in the setting of coronavirus disease-19 (COVID-19) because it is easily available, can be performed bedside and repeated over time. We herein examined LUS patterns in relation to disease severity and disease stage among patients with COVID-19 pneumonia. Methods. We performed a retrospective case series analysis of patients with confirmed SARS-CoV-2 infection who were admitted to the hospital because of pneumonia. We recorded history, clinical parameters and medications. LUS was performed and scored in a standardized fashion by experienced operators, with evaluation of up to 12 lung fields, reporting especially on B-lines and consolidations. Results. We included 96 patients, 58.3% men, with a mean age of 65.9 years. Patients with a high-risk quick COVID-19 severity index (qCSI) were older and had worse outcomes, especially for the need for high-flow oxygen. B-lines and consolidations were located mainly in the lower posterior lung fields. LUS patterns for B-lines and consolidations were significantly worse in all lung fields among patients with high versus low qCSI. B-lines and consolidations were worse in the intermediate disease stage, from day 7 to 13 after onset of symptoms. While consolidations correlated more with inflammatory biomarkers, B-lines correlated more with end-organ damage, including extrapulmonary involvement. Conclusions. LUS patterns provide a comprehensive evaluation of patients with COVID-19 pneumonia that correlated with severity and dynamically reflect disease stage. LUS patterns may reflect different pathophysiological processes related to inflammation or tissue damage; consolidations may represent a more specific sign of localized disease, whereas B-lines seem to be also dependent upon generalized illness due to SARS-CoV-2 infection.

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Prolonged survival after talc poudrage for malignant pleural mesothelioma: Case series

Respirology ◽

10.1111/j.1440-1843.2005.00763.x ◽

2005 ◽

Vol 10 (5) ◽

pp. 649-655 ◽

Cited By ~ 22

Author(s):

Yossef AELONY ◽

Janis F. YAO

Keyword(s):

Malignant Pleural Mesothelioma ◽

Case Series ◽

Prolonged Survival ◽

Pleural Mesothelioma ◽

Talc Poudrage

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Autotransplantation of mature impacted tooth to a fresh molar socket using a 3D replica and guided bone regeneration: two years retrospective case series

10.21203/rs.2.12324/v4 ◽

2019 ◽

Author(s):

Ye Wu ◽

Jiaming Chen ◽

Fuping Xie ◽

Huanhuan Liu ◽

Gang Niu ◽

...

Keyword(s):

Clinical Outcome ◽

Bone Regeneration ◽

Case Series ◽

Guided Bone Regeneration ◽

Third Molars ◽

Retrospective Case ◽

Impacted Tooth ◽

Probing Depth ◽

One Year

Abstract Background: The aim of this study was to evaluate the clinical outcome of autotransplantation of mature third molars to fresh molar extraction sockets using 3D replicas. Methods: Ten patients underwent teeth autotransplantation with or without GBR. We observed the mobility, percussion, radiography examination, the probing depth and the masticatory function of the transplanted teeth during two years following up, which were transplanted into fresh molar sockets by using 3D replicas, and GBR when it is necessary. Results: The average extra-oral time of donor tooth had been shortened to 1.65 min when used the 3D replica. Some probing depth of the transplanted tooth were deeper than 3 mm at 4 or 5 weeks temporarily. And one patient felt slight sensitive when chewing with soft food at 4 weeks, then disappeared. The clinical examination of the autotransplantation teeth during one year follow-up showed no sign of failure. Conclusions: The tooth autotransplantation using 3D replica with or without GBR is an effective method which can reduce the extra-oral time of the donor teeth and may result in less failure.

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Modified Langenskiöld procedure for chronic, recurrent, and congenital patellar dislocation

Journal of Children s Orthopaedics ◽

10.1302/1863-2548.14.200044 ◽

2020 ◽

Vol 14 (4) ◽

pp. 318-329

Author(s):

Omar Ramos ◽

Corey Burke ◽

Molly Lewis ◽

Martin J. Morrison ◽

Dror Paley ◽

...

Keyword(s):

Knee Flexion ◽

Patellar Dislocation ◽

Case Series ◽

Retrospective Case ◽

Level Of Evidence ◽

Full Extension ◽

Chronic Group ◽

Patellar Maltracking ◽

Kujala Score ◽

One Year

Purpose Langenskiöld described a reconstructive soft-tissue procedure for irreducible lateral congenital patellar dislocations. Paley further detailed the technique in the surgical management of congenital femoral deficiency. The aim of this study was to evaluate the outcomes of patients with congenital, chronic and recurrent patellar dislocations treated with the modified Langenskiöld procedure. Methods This is a retrospective case series. Between 2011 and 2018, 18 knees in 13 patients (mean age 15.8 years (sd 4.4; 12 to 29.9), nine female) with diagnoses of recurrent (six patients, eight knees), chronic (four patients, six knees) and congenital (three patients, four knees) patellar dislocations were treated with the modified Langenskiöld procedure. Results There were no recurrent lateral dislocations in the congenital or recurrent groups. One of the patients in the congenital group had an overcorrection with some medial patellar maltracking but until this time has not required any further surgery. In the chronic group two of the six knees developed further dislocations; these were both on the same patient, who had no dislocations until one year after surgery. Mean Kujala score was 83.7 (sd 17; 47 to 100) for all groups. In spite of preoperative knee flexion contractures of up to 30° in three patients (six knees), all patients had full extension postoperatively. Eight patients reported being satisfied with their outcome, one was somewhat satisfied, two were very dissatisfied, and two did not respond. Conclusion The modified Langenskiöld reconstruction provides a powerful correction for challenging cases of congenital and recurrent patellar dislocations. Re-dislocation as well as overcorrection can occasionally occur. Level of Evidence Level IV

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