81 The uniqueness of the United Kingdom Lung Cancer Screening trial (UKLS) – a population screening study

McRonald, Fiona E.; Baldwin, David R; Devaraj, Anand; Brain, Katherine Emma; Eisen, Tim; Holeman, J.; Ledson, M.J.; Screaton, Nicholas; Rintoul, Robert C.; Yadegarfar, Ghasem; Hands, Caroline; Lifford, Kate; Whynes, David K.; Kerr, Keith M.; Page, Richard; Parmar, Max; Weller, David; Williamson, Paula; Hansell, David M.; Duffy, SW; Field, John K.

doi:10.1016/s0169-5002(13)70081-3

Cited by 2 publications

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“…Surgical case series have reports of survival of up to 30% at five years in highly selected populations (reviewed in [86]). The only two randomised controlled trials published to date have failed to demonstrate any survival benefit [87,88], either by EPP or by video-assisted partial pleurectomy, with adjuvant chemotherapy and/or radiotherapy [88,89]. The complications of surgery and adjunct therapy are significant [86] and, at present, there is no agreed established role for radical surgery in managing MPM [90] with widespread acceptance that such advanced operations should only be conducted in high volume specialist surgical centres, ideally as part of clinical trials [91].…”

Section: Treatment Of Mesotheliomamentioning

confidence: 99%

Epidemiology and Clinical Aspects of Malignant Pleural Mesothelioma

Brims

2021

Cancers

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Mesothelioma is a cancer predominantly of the pleural cavity. There is a clear association of exposure to asbestos with a dose dependent risk of mesothelioma. The incidence of mesothelioma in different countries reflect the historical patterns of commercial asbestos utilisation in the last century and predominant occupational exposures mean that mesothelioma is mostly seen in males. Modern imaging techniques and advances in immunohistochemical staining have contributed to an improved diagnosis of mesothelioma. There have also been recent advances in immune checkpoint inhibition, however, mesothelioma remains very challenging to manage, especially considering its limited response to conventional systemic anticancer therapy and that no cure exists. Palliative interventions and support remain paramount with a median survival of 9–12 months after diagnosis. The epidemiology and diagnosis of mesothelioma has been debated over previous decades, due to a number of factors, such as the long latent period following asbestos exposure and disease occurrence, the different potencies of the various forms of asbestos used commercially, the occurrence of mesothelioma in the peritoneal cavity and its heterogeneous pathological and cytological appearances. This review will describe the contemporary knowledge on the epidemiology of mesothelioma and provide an overview of the best clinical practice including diagnostic approaches and management.

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Section: Treatment Of Mesotheliomamentioning

confidence: 99%

Epidemiology and Clinical Aspects of Malignant Pleural Mesothelioma

Brims

2021

Cancers

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“…However, the latest American Society of Clinical Oncology guideline for treatment of MPM recommended that a maximal surgical cytoreduction (hereafter referred to as surgery) should be considered in selected patients with early-stage disease. [12][13][14][15] Radical surgical treatments for MPM include extrapleural pneumonectomy (EPP: removal of the lung, parietal pleura, pericardium, and part of the diaphragm) or pleurectomy/decortication (P/D: removal of the parietal pleura and tumor bulk from the lung or surrounding tissues). Perioperative morbidity and mortality is lower with P/D and these operations are offered in specialized surgical centers around the world.…”

Section: Introductionmentioning

confidence: 99%

Prediction modelling using routine clinical parameters to stratify survival in Malignant Pleural Mesothelioma patients undergoing cytoreductive surgery

Harris

Kao

McCaughan

et al. 2019

Journal of Thoracic Oncology

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Introduction: Malignant pleural mesothelioma (MPM) is an uncommon cancer with a poor prognosis and heterogeneous survival. Surgery for MPM is offered in some specialist centers to highly selected patients. A previously described classification and regression tree (CART) model stratified survival in unselected MPM patients using routinely collected clinical data. This study aimed to examine the performance of this CART model on a highly selected surgical population. Methods: Data were collected from subjects undergoing cytoreductive surgery for MPM from specialist centers in Hyõgo, Japan, and Sydney, Australia, between 1991 and 2016. The CART model was applied using the combination of clinical variables to stratify subjects into risk groups (1 through 4); survival characteristics were then compared. Results: Two hundred eighty-nine cases were included (205 from Australia, 84 from Japan). Overall median survival was 34.6 (interquartile range: 17.5-56.1) months; median age was 63.0 (interquartile range: 57.0-67.8) years, and 83.0% (n ¼ 240) were male. There were no clinically meaningful differences between the two cohorts. Survival across the four risk groups was significantly different (p < 0.0001); the model stratified survival well with a Harrell's concordance statistic of 0.62 (95% confidence interval: 0.57-0.66) at 36 months. The group with the longest survival (median, 82.5 months) had: no weight loss, hemoglobin > 153 g/L and serum albumin > 43 g/L at time of referral to the surgical center. Conclusions: Using routinely available clinical variables, the CART model was able to stratify surgical patients into risk groups with statistically different survival

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81 The uniqueness of the United Kingdom Lung Cancer Screening trial (UKLS) – a population screening study

Cited by 2 publications

References 0 publications

Epidemiology and Clinical Aspects of Malignant Pleural Mesothelioma

Epidemiology and Clinical Aspects of Malignant Pleural Mesothelioma

Prediction modelling using routine clinical parameters to stratify survival in Malignant Pleural Mesothelioma patients undergoing cytoreductive surgery

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