Extended pleurectomy/decortication yields greater improvement to a patient’s quality of life if the surgical procedure is performed when significant mesothelioma symptoms are present, as opposed to when there are none. These new findings come from University of Chicago researchers.
The researchers also found that the quality-of-life improvements derived from extended pleurectomy/decortication — EPD — lasted for many months postoperatively.
However, the benefits of this form of maximal cytoreductive surgery did not extend to pulmonary function.
Writing in the online edition of The Annals of Thoracic Surgery, the researchers reported little or no improvements in pulmonary function following EPD.
Interesting, too, and certainly disappointing, was the observation that EPD performed on mesothelioma patients who were minimally symptomatic experienced no quality-of-life improvement.
Together, these findings led the researchers to conclude that EPD was a good mesothelioma surgery choice for substantially symptomatic patients/ However, it only hold true if the objective was to improve health-related quality of life, and not to improve pulmonary function.
Study Focuses on Pleural Mesothelioma Patients
The researchers based these conclusions on the results of a study they conducted with 36 malignant pleural mesothelioma patients.
The patients were examined before undergoing mesothelioma surgery and then four or five months after the procedure. The patients were seen one more time between three or four months later.
At each examination, the mesothelioma patients were asked questions about their health-related quality of life. The questions were drawn from the Core Quality of Life questionnaire developed by the European Organization for Research and Treatment of Cancer.
The researchers also performed pulmonary function tests of the enrolled mesothelioma patients and compared the test results against the performance-status baseline developed by the World Health Organization.
The first pulmonary function test was conducted just prior to the surgery. The second was conducted at one, but not both, of the postoperative follow-up visits.
Seventeen of the mesothelioma patients had a performance status rating of 0. The remaining 19 had a performance status rating of 1 or 2.
Some Mesothelioma Patients’ Scores Improved
The researchers indicated that the mesothelioma patients with a performance status of 1 or 2 had poor global health, functional and symptoms scores in comparison to those with a performance status of 0.
Following surgery, the mesothelioma patients with a performance status of 0 experienced no change in global health, functional and symptoms scores. The only improvement was to their emotional scores.
Also, the mesothelioma patients with a performance status of 0 showed less lung function and lung capacity after surgery.
There was a “significant decrease in forced vital capacity, forced expiratory volume in 1-second total lung capacity, and diffusing capacity of the lung for carbon monoxide,” the researchers wrote.
On the other hand, the mesothelioma patients with performance status ratings of 1 or 2 experienced no such decrease after surgery.
“Extended pleurectomy and decortication results in equivalent survival yet better health-related quality of life,” the researchers decided.
The study is entitled “Effects Of Extended Pleurectomy and Decortication on Quality of Life and Pulmonary Function in Patients with Malignant Pleural Mesothelioma.”