Asbestos Research Today is a free monthly online journal that collates and summarizes the latest research about Asbestos, including details on mesothelioma, lung disease, dangers, effects, risks. | ||||||||
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Surgical management of malignant pleural mesothelioma: a systematic review and evidence summary.Maziak DE, Gagliardi A, Haynes AE, Mackay JA, Evans WK, University of Ottawa, Ottawa Hospital, General Campus, 501 Smyth Road, Ottawa, Ont., Canada K1H 8L6. haynesa@mcmaster.ca An evidence summary was developed for the surgical management of adult patients with diffuse or localized malignant pleural mesothelioma. This evidence summary is based on a systematic search and review of the literature published between 1985 and February 2004. Relevant studies were identified, according to pre-determined criteria by the authors and methodologists. No randomized controlled trials comparing pleurectomy (PL) with extrapleural pneumonectomy (EPP) or comparing surgery with an alternative treatment were identified. Four comparative studies, seven non-comparative prospective studies, and 16 retrospective case series were identified that looked at PL, or EPP, or PL and EPP. Trial results were not pooled due to the heterogeneity of the treatments in the trials and the fact that no trials were randomized and none were designed to directly compare different treatments. External feedback was obtained from Ontario clinicians, and the provincial Lung Cancer Disease Site Group approved the review. CONCLUSIONS: The role of surgery in the management of malignant pleural mesothelioma cannot be precisely defined as the lack of randomized controlled clinical trials makes it impossible to determine whether the use of EPP or PL improves survival or effectively palliates the symptoms of the disease. Future studies of the role of surgery in the treatment of mesothelioma should include evaluations of quality of life. Published 14 April 2005 in Lung Cancer, 48(2): 157-69.
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