Clinical Impact of Extrapleural Pneumonectomy for Malignant Pleural Mesothelioma

Background The clinical impact of extrapleural pneumonectomy in malignant pleural mesothelioma is poorly investigated. Methods Between 1997 and 2007, 29 consecutive patients underwent extrapleural pneumonectomy for mesothelioma and adjuvant chemoradiotherapy. Function (spirometry, arterial blood gas analysis, 6-min walk test, and echocardiographic fraction ejection estimation), symptoms (quantification of pain, dyspnea, cough, fever, weight loss, and Karnofsky performance status) and quality of life [Medical Outcomes Study Short Form, 36 item (SF-36) and St. George’s Respiratory Questionnaire] were timely evaluated. Data were prospectively collected and retrospectively reviewed. Results Only one postoperative death occurred. 30-day postoperative morbidity was 41%. Median survival was 19.5 months with 17 patients still alive at 1 year and 10 at 2 years, respectively. At 3 months, the expected decrement of forced expiratory volume in 1 s ( P = 0.06) and forced vital capacity ( P = 0.09) was not significant. Conversely, arterial blood gas, 6-min walk test, cardiac fraction ejection, pain ( P