Extra-pleural pneumonectomy vs. no extra-pleural pneumonectomy for malignant pleural mesothelioma
Author Information
Author(s): Tom Treasure, Loic Lang-Lazdunski, David Waller, Judith M Bliss, Carol Tan, James Entwisle, Michael Snee, Mary O'Brien, Gill Thomas, Suresh Senan, Ken O'Byrne, Lucy S Kilburn, James Spicer, David Landau, John Edwards, Gill Coombes, Liz Darlison, Julian Peto
Primary Institution: University College London
Hypothesis
Does extra-pleural pneumonectomy improve survival and quality of life in patients with malignant pleural mesothelioma compared to no surgery?
Conclusion
The study suggests that extra-pleural pneumonectomy offers no survival benefit and may harm patients compared to no surgery.
Supporting Evidence
- 112 patients were registered, and 50 were randomly assigned to treatment.
- EPP was completed satisfactorily in 16 of 24 patients assigned to EPP.
- Median survival was 14.4 months for the EPP group and 19.5 months for the no EPP group.
- Quality of life scores were lower in the EPP group, but no significant differences were reported.
- 30-day mortality was 12.5% in the EPP group.
Takeaway
This study looked at whether a type of surgery helps people with a serious lung disease. It found that the surgery didn't help and might even make things worse.
Methodology
A multicentre randomised controlled trial in 12 UK hospitals with patients randomly assigned to either EPP or no EPP after chemotherapy.
Potential Biases
Patients and investigators were not masked to treatment allocation, which could introduce bias.
Limitations
The study had a small sample size and was not masked, which may affect the reliability of the results.
Participant Demographics
Patients aged 18 years or older with pathologically confirmed mesothelioma.
Statistical Information
P-Value
0.016
Confidence Interval
95% CI 1.21–6.26
Statistical Significance
p=0.016
Digital Object Identifier (DOI)
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