BTS statement on malignant mesothelioma in the UK, 2007

,

doi:10.1136/thx.2007.087619

Cited by 106 publications

(45 citation statements)

References 81 publications

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“…The variability in caseload between hospitals relates to the size of the hospital and the population it serves, as well as the historical use of asbestos in local industries, such as shipyards and power stations. This finding reinforces the need to develop regional structures such as "specialist MDTs" [6,7] in order to develop the experience and expertise of medical and nursing staff, and to ensure that patients have access to the whole range of diagnostic and therapeutic options, include clinical trials.…”

Section: Discussionsupporting

confidence: 66%

“…In 2007 the British Thoracic Society published a statement document on the management of MPM [6] and in the same year the English Department of Health published guidance on the organisation of services for MPM [7]. The aim of these publications was to raise the awareness of MPM and to encourage multidisciplinary management by specialist clinical teams.…”

Section: Introductionmentioning

confidence: 98%

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Demographics, management and survival of patients with malignant pleural mesothelioma in the National Lung Cancer Audit in England and Wales

et al. 2015

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Section: Discussionsupporting

confidence: 66%

Section: Introductionmentioning

confidence: 98%

Demographics, management and survival of patients with malignant pleural mesothelioma in the National Lung Cancer Audit in England and Wales

et al. 2015

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“…[515253] However, until the results of new ongoing studies are known, the British Thoracic Society suggests that prophylactic radiation therapy may have a role in patients with good general condition. [54]…”

Section: Medical Pleuroscopymentioning

confidence: 99%

Pleural procedures in the management of malignant effusions

Ferreiro¹,

Suárez-Antelo

Valdés³

2017

Ann Thorac Med

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Malignant pleural effusion (MPE) is common in clinical practice, and despite the existence of studies to guide clinical decisions, it often poses diagnostic and therapeutic dilemmas. Once it is diagnosed, median survival does not usually exceed 6 months. The management of these patients focuses on symptom relief since no treatments have been shown to increase survival to date. Conversely, poor management can shorten survival. The approach must be multidisciplinary and allow for individualized care. Initial diagnostic procedures should be minimally invasive and, according to the results and other factors, procedures of increasing complexity will be selecting. Likewise, the treatment of MPEs should be individualized according to factors such as type of tumor, patient functional status, means available, benefits of each procedure, or life expectancy. Currently, treatment seems to tend toward less interventional approaches, in which patients can be managed on an outpatient basis, thus minimizing both the discomfort that more aggressive approaches involve and the costs of care associated with this disease. This article reviews the pleural procedures employed in the management of MPEs with special emphasis on the indication for each one, its usefulness, benefits, and complications.

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“…It is notable that, in Davies' series [37], there was no false-negative outcome in cases with a low pre-thoracoscopic clinical suspicion of malignancy and all five false-negative outcomes occurred in patients with high level of suspicion prior to thoracoscopy. This episode clearly indicates that physicians should consider further diagnostic procedures in patients with high level suspicion but without definitive diagnosis of MPM [66].…”

Section: Commentsmentioning

confidence: 92%

“…This is the most controversial situation. Follow up with interval CT or repeated biopsy is recommended by guidelines [14,66]. However, repeated biopsies often result in the same uncertain diagnosis.…”

Section: A Practical Scenario Of Diagnosing Radiological T0 Mpmmentioning

confidence: 98%

Practical approaches to diagnose and treat for T0 malignant pleural mesothelioma: a proposal for diagnostic total parietal pleurectomy

et al. 2012

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Malignant pleural mesothelioma (MPM) remains suffering poor prognosis in spite of recent diagnostic and therapeutic progress. Although there is currently no established evidence, early diagnosis and early intervention may play a key role to improve prognosis of MPM, similarly to other malignancies. As pleural effusion is usually the first clinical sign of MPM, pleural effusion cytology is often the first diagnostic examination to be carried out. Since the sensitivity of pleural effusion cytology is approximately 60%, however, false-negative diagnosis is given to almost half of true MPM patients at this clinical step. One practical way to reduce the number of misdiagnosed MPM is to encourage performing thoracoscopic pleural biopsy unless definitive diagnosis other than MPM is established. There still remain a considerable number of patients with radiological/thoracoscopic T0 MPM who are misdiagnosed with nonspecific pleuritis after a complete investigation including thoracoscopic biopsies. Such patients will turn out to be malignant during follow-up period, although they have the best opportunity for long-term survival if only early therapeutic intervention is given. Currently, we are performing diagnostic total parietal pleurectomy in highly selected patients, who are characterized with strong clinical suspicion, positive pleural effusion cytology but uncertain pathological diagnosis, excellent cardiopulmonary reserve, and with written informed consent for highly invasive diagnostic surgery for pathologically unproven disease.

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BTS statement on malignant mesothelioma in the UK, 2007

Cited by 106 publications

References 81 publications

Demographics, management and survival of patients with malignant pleural mesothelioma in the National Lung Cancer Audit in England and Wales

Demographics, management and survival of patients with malignant pleural mesothelioma in the National Lung Cancer Audit in England and Wales

Pleural procedures in the management of malignant effusions

Practical approaches to diagnose and treat for T0 malignant pleural mesothelioma: a proposal for diagnostic total parietal pleurectomy

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