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Klotz LV, Casjens S, Johnen G, Taeger D, Brik A, Eichhorn F, Förster L, Kaiser N, Muley T, Stolp C, Schneider M, Gleichenhagen J, Brüning T, Winter H, Eichhorn M, Weber DG. Combination of calretinin, MALAT1, and GAS5 as a potential prognostic biomarker to predict disease progression in surgically treated mesothelioma patients. Lung Cancer 2024; 192:107802. [PMID: 38692217 DOI: 10.1016/j.lungcan.2024.107802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 04/20/2024] [Accepted: 04/23/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND The role of cytoreductive surgery for epithelioid pleural mesothelioma within a multimodal treatment approach remains controversial. Carefully selected patients benefit from cytoreductive surgery and adjuvant chemotherapy, but there is no established biomarker to predict tumor recurrence or progression during the course of the disease. The aim of this study was to identify potential biomarkers to predict therapeutic response in terms of progression-free survival. METHODS Between 03/2014 and 08/2022, preoperative blood samples were collected from 76 patients with epithelioid pleural mesothelioma who underwent cytoreductive surgery as part of a multimodal treatment approach. Identification of potential biomarkers was performed by determination of mesothelin and calretinin, as well as specific long non-coding RNAs and microRNAs. Receiver operating characteristic analysis, Kaplan-Meier survival analysis, and Cox regression were used to assess the association between biomarker concentrations and patient recurrence status and survival. RESULTS MALAT1, GAS5, and calretinin showed statistically significant increased biomarker levels in patients with recurrence in contrast to recurrence-free patients after surgical treatment (p < 0.0001, p = 0.0190, and p = 0.0068, respectively). The combination of the three biomarkers resulted in a sensitivity of 68 % and a specificity of 89 %. CONCLUSION MALAT1, GAS5, and calretinin could be potential biomarkers for the prediction of tumor recurrence, improving the benefit from multimodal treatment including cytoreductive surgery.
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Affiliation(s)
- Laura V Klotz
- Department of Thoracic Surgery, Thoraxklinik, University of Heidelberg, Roentgenstraße 1, 69126 Heidelberg, Germany; German Center for Lung Research (TLRC), Germany; Division of Molecular Thoracic Oncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
| | - Swaantje Casjens
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bürkle-de-la-Camp Platz 1, 44789 Bochum, Germany
| | - Georg Johnen
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bürkle-de-la-Camp Platz 1, 44789 Bochum, Germany
| | - Dirk Taeger
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bürkle-de-la-Camp Platz 1, 44789 Bochum, Germany
| | - Alexander Brik
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bürkle-de-la-Camp Platz 1, 44789 Bochum, Germany
| | - Florian Eichhorn
- Department of Thoracic Surgery, Thoraxklinik, University of Heidelberg, Roentgenstraße 1, 69126 Heidelberg, Germany; German Center for Lung Research (TLRC), Germany
| | - Laura Förster
- Section for Translational Research, Thoraxklinik, University of Heidelberg, Roentgenstraße 1, 69126 Heidelberg, Germany
| | - Nina Kaiser
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bürkle-de-la-Camp Platz 1, 44789 Bochum, Germany
| | - Thomas Muley
- German Center for Lung Research (TLRC), Germany; Section for Translational Research, Thoraxklinik, University of Heidelberg, Roentgenstraße 1, 69126 Heidelberg, Germany
| | - Christa Stolp
- Section for Translational Research, Thoraxklinik, University of Heidelberg, Roentgenstraße 1, 69126 Heidelberg, Germany
| | - Marc Schneider
- German Center for Lung Research (TLRC), Germany; Section for Translational Research, Thoraxklinik, University of Heidelberg, Roentgenstraße 1, 69126 Heidelberg, Germany
| | - Jan Gleichenhagen
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bürkle-de-la-Camp Platz 1, 44789 Bochum, Germany
| | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bürkle-de-la-Camp Platz 1, 44789 Bochum, Germany
| | - Hauke Winter
- Department of Thoracic Surgery, Thoraxklinik, University of Heidelberg, Roentgenstraße 1, 69126 Heidelberg, Germany; German Center for Lung Research (TLRC), Germany
| | - Martin Eichhorn
- Department of Thoracic Surgery, Thoraxklinik, University of Heidelberg, Roentgenstraße 1, 69126 Heidelberg, Germany; German Center for Lung Research (TLRC), Germany
| | - Daniel G Weber
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bürkle-de-la-Camp Platz 1, 44789 Bochum, Germany
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2
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Schelch K, Eder S, Zitta B, Phimmachanh M, Johnson TG, Emminger D, Wenninger‐Weinzierl A, Sturtzel C, Poplimont H, Ries A, Hoetzenecker K, Hoda MA, Berger W, Distel M, Dome B, Reid G, Grusch M. YB-1 regulates mesothelioma cell migration via snail but not EGFR, MMP1, EPHA5 or PARK2. Mol Oncol 2024; 18:815-831. [PMID: 36550787 PMCID: PMC10994239 DOI: 10.1002/1878-0261.13367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 11/11/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022] Open
Abstract
Pleural mesothelioma (PM) is characterized by rapid growth, local invasion, and limited therapeutic options. The multifunctional oncoprotein Y-box-binding protein-1 (YB-1) is frequently overexpressed in cancer and its inhibition reduces aggressive behavior in multiple tumor types. Here, we investigated the effects of YB-1 on target gene regulation and PM cell behavior. Whereas siRNA-mediated YB-1 knockdown reduced cell motility, YB-1 overexpression resulted in scattering, increased migration, and intravasation in vitro. Furthermore, YB-1 stimulated PM cell spreading in zebrafish. Combined knockdown and inducible overexpression of YB-1 allowed bidirectional control and rescue of cell migration, the pattern of which was closely followed by the mRNA and protein levels of EGFR and the protein level of snail, whereas the mRNA levels of MMP1, EPHA5, and PARK2 showed partial regulation by YB-1. Finally, we identified snail as a critical regulator of YB-1-mediated cell motility in PM. This study provides insights into the mechanism underlying the aggressive nature of PM and highlights the important role of YB-1 in this cancer. In this context, we found that YB-1 closely regulates EGFR and snail, and, moreover, that YB-1-induced cell migration depends on snail.
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Affiliation(s)
- Karin Schelch
- Center for Cancer Research and Comprehensive Cancer CenterMedical University of ViennaAustria
- Department of Thoracic SurgeryMedical University of ViennaAustria
| | - Sebastian Eder
- Center for Cancer Research and Comprehensive Cancer CenterMedical University of ViennaAustria
| | - Benjamin Zitta
- Center for Cancer Research and Comprehensive Cancer CenterMedical University of ViennaAustria
| | - Monica Phimmachanh
- Center for Cancer Research and Comprehensive Cancer CenterMedical University of ViennaAustria
- University of Technology SydneyNSWAustralia
| | - Thomas G. Johnson
- Center for Cancer Research and Comprehensive Cancer CenterMedical University of ViennaAustria
- The University of SydneyNSWAustralia
| | - Dominik Emminger
- Center for Cancer Research and Comprehensive Cancer CenterMedical University of ViennaAustria
| | | | - Caterina Sturtzel
- St. Anna Children's Cancer Research Institute, Innovative Cancer ModelsViennaAustria
| | - Hugo Poplimont
- St. Anna Children's Cancer Research Institute, Innovative Cancer ModelsViennaAustria
| | - Alexander Ries
- Center for Cancer Research and Comprehensive Cancer CenterMedical University of ViennaAustria
| | | | - Mir A. Hoda
- Department of Thoracic SurgeryMedical University of ViennaAustria
| | - Walter Berger
- Center for Cancer Research and Comprehensive Cancer CenterMedical University of ViennaAustria
| | - Martin Distel
- St. Anna Children's Cancer Research Institute, Innovative Cancer ModelsViennaAustria
| | - Balazs Dome
- Department of Thoracic SurgeryMedical University of ViennaAustria
- National Koranyi Institute of PulmonologyBudapestHungary
- Department of Thoracic SurgerySemmelweis University and National Institute of OncologyBudapestHungary
| | - Glen Reid
- Department of PathologyDunedin School of MedicineNew Zealand
- The Maurice Wilkins CentreUniversity of OtagoDunedinNew Zealand
| | - Michael Grusch
- Center for Cancer Research and Comprehensive Cancer CenterMedical University of ViennaAustria
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3
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Febres-Aldana CA, Fanaroff R, Offin M, Zauderer MG, Sauter JL, Yang SR, Ladanyi M. Diffuse Pleural Mesothelioma: Advances in Molecular Pathogenesis, Diagnosis, and Treatment. ANNUAL REVIEW OF PATHOLOGY 2024; 19:11-42. [PMID: 37722697 DOI: 10.1146/annurev-pathol-042420-092719] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
Diffuse pleural mesothelioma (DPM) is a highly aggressive malignant neoplasm arising from the mesothelial cells lining the pleural surfaces. While DPM is a well-recognized disease linked to asbestos exposure, recent advances have expanded our understanding of molecular pathogenesis and transformed our clinical practice. This comprehensive review explores the current concepts and emerging trends in DPM, including risk factors, pathobiology, histologic subtyping, and therapeutic management, with an emphasis on a multidisciplinary approach to this complex disease.
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Affiliation(s)
- Christopher A Febres-Aldana
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA; ,
| | - Rachel Fanaroff
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA; ,
| | - Michael Offin
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Marjorie G Zauderer
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jennifer L Sauter
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA; ,
| | - Soo-Ryum Yang
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA; ,
| | - Marc Ladanyi
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA; ,
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4
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Qin C, Xia Q, Chen Z, Zhou Q, Zheng X. En bloc resection of the recurrent pleural mesothelioma and reconstruction of the chest wall after immunotherapy: A case report. Thorac Cancer 2023; 14:3063-3066. [PMID: 37658846 PMCID: PMC10599967 DOI: 10.1111/1759-7714.15095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/19/2023] [Accepted: 08/21/2023] [Indexed: 09/05/2023] Open
Abstract
Malignant pleural mesothelioma (MPM) is associated with previous asbestos exposure, while more clinical insights into this disease have come from other case studies. Maximal cytoreduction is critical in disease control and might help to improve the prognosis. Here, a 41-year-old female presented with a 6-month history of a mass detected in the chest wall following resection of a right pleural mesothelioma 2 years previously. A fluorodeoxyglucose positron emission tomography/computed tomography scan showed a right chest wall mass with a blurred boundary 8.9 cm × 3.7 cm in size. The patient had received one cycle of bevacizumab, carboplatin, and pemetrexed, and two cycles of nivolumab, ipilimumab, and gemcitabine 5 months before admission. We subsequently resected the tumor, the involved diaphragm, and the fifth and sixth ribs, and titanium mesh and continuous suture were used to close the thoracic cage. The fixed paraffin-embedded tissues showed epithelioid pleural mesothelioma. The patient received nivolumab and ipilimumab postoperatively, and no recurrence was detected 16 months after surgery. En bloc resection with reconstructive surgery effectively removed the locally advanced malignancy and restored the biological function of the thorax with a favorable prognosis. Neoadjuvant immunotherapy might therefore be conducive to radical resection and perioperative immunotherapy might improve the prognosis.
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Affiliation(s)
- Changlong Qin
- Lung Cancer Center, West China HospitalSichuan UniversityChengduPeople's Republic of China
- Lung Cancer Institute, West China Hospital, Sichuan UniversityChengduPeople's Republic of China
| | - Qinghong Xia
- Operating Room of Anesthesia Surgery Center, West China HospitalSichuan UniversityChengduPeople's Republic of China
- West China School of NursingSichuan UniversityChengduPeople's Republic of China
| | - Zi‐Jia Chen
- Lung Cancer Center, West China HospitalSichuan UniversityChengduPeople's Republic of China
- Lung Cancer Institute, West China Hospital, Sichuan UniversityChengduPeople's Republic of China
| | - Qinghua Zhou
- Lung Cancer Center, West China HospitalSichuan UniversityChengduPeople's Republic of China
- Lung Cancer Institute, West China Hospital, Sichuan UniversityChengduPeople's Republic of China
| | - Xi Zheng
- Lung Cancer Center, West China HospitalSichuan UniversityChengduPeople's Republic of China
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5
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Nakamura A, Hashimoto M, Kondo N, Matsumoto S, Nakamichi T, Kuribayashi K, Kijima T, Kodama H, Yamakado K, Hasegawa S. Long-term outcomes and risk factors of residual thoracic spaces after pleurectomy/decortication for mesothelioma. Eur J Cardiothorac Surg 2022; 63:6763486. [PMID: 36259940 DOI: 10.1093/ejcts/ezac500] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 09/28/2022] [Accepted: 10/17/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES The residual thoracic spaces (RTS) after pleurectomy/decortication (P/D) remain unexplored to date. Hence, this study aims to examine the details and risk factors of RTS during the 3 post-P/D months. METHODS We retrospectively examined patients who underwent neoadjuvant chemotherapy, followed by P/D for malignant pleural mesothelioma from September 2012 to December 2020. The RTS group included cases of residual thoracic cavity unaccompanied by pleural effusion on 3 postoperative months computed tomography. We determined risk factors for RTS using univariable and multivariable analyses. RESULTS Of 170 patients examined, 58 (34.1%) were in the RTS group and 112 (65.9%) in the non-RTS group. In the RTS group, 43 patients recovered from RTS during the follow-up period; 4 patients developed chronic fistular empyema, while 2 required fenestration and 2 were thoracoscopic debridement. Besides, 11 patients exhibited RTS continuously. The univariable analysis revealed that compared with the non-RTS group, the RTS group reported a significantly longer postoperative air leak (>7 days; P < 0.01) and right P/D (P = 0.04). The multivariable analysis demonstrated that longer postoperative air leak (>7 days) remained a risk factor for RTS (odds ratio 2.5, 95% confidence interval: 1.3-4.9, P < 0.01). CONCLUSIONS RTS was a postoperative event that frequently observed in patients undergoing P/D. Overall, the current study findings suggest longer postoperative air leak (>7 days) as a significant risk factor for RTS.
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Affiliation(s)
- Akifumi Nakamura
- Division of Thoracic Surgery, Department of Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Masaki Hashimoto
- Division of Thoracic Surgery, Department of Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Nobuyuki Kondo
- Division of Thoracic Surgery, Department of Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Seiji Matsumoto
- Division of Thoracic Surgery, Department of Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Toru Nakamichi
- Division of Thoracic Surgery, Department of Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Kozo Kuribayashi
- Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Takashi Kijima
- Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Hiroshi Kodama
- Department of Radiology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Koichiro Yamakado
- Department of Radiology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Seiki Hasegawa
- Division of Thoracic Surgery, Department of Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
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6
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Bellini A, Mazzarra S, Sterrantino S, Argnani D, Stella F. Second Surgery for Recurrent Malignant Pleural Mesothelioma after Multimodality Treatment: A Systematic Review. J Clin Med 2022; 11:jcm11123340. [PMID: 35743417 PMCID: PMC9225173 DOI: 10.3390/jcm11123340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/06/2022] [Accepted: 06/08/2022] [Indexed: 02/01/2023] Open
Abstract
Malignant pleural mesothelioma (MPM) is an aggressive asbestos-related tumour with poor prognosis. To date, a multimodality treatment, including chemotherapy and surgery, with or without radiotherapy, is the gold standard therapy for selected patients with epithelioid and early-stage MPM. In this setting, the goal of surgery is to achieve the macroscopic complete resection, obtained by either extrapleural pneumonectomy or pleurectomy/decortication. Failure, in local and/or distant sites, is one of the major concerns; in fact, there has been no established treatment for the recurrence of MPM after the multimodal approach, and the role of surgery in this context is still controversial. By using electronic databases, studies that included recurrent MPM patients who underwent a second surgery were identified. The endpoints included were: a pattern of recurrence, post-recurrence survival (PRS), and the type of second surgery. When available, factors predicting better PRS and perioperative mortality and morbidity were collected. This systematic review offers an overview of the results that are currently obtained in patients undergoing a second surgery for relapsed MPM, with the aim to provide a comprehensive view on this subject that explores if a second surgery leads to an improvement in survival.
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Affiliation(s)
- Alice Bellini
- Department of Surgery, Division of Thoracic Surgery, G.B. Morgagni—L. Pierantoni Hospital, Via Carlo Forlanini n.34, 47121 Forlì, Italy; (S.M.); (S.S.); (D.A.); (F.S.)
- Correspondence: ; Tel.: +39-0543-735650
| | - Sara Mazzarra
- Department of Surgery, Division of Thoracic Surgery, G.B. Morgagni—L. Pierantoni Hospital, Via Carlo Forlanini n.34, 47121 Forlì, Italy; (S.M.); (S.S.); (D.A.); (F.S.)
| | - Sara Sterrantino
- Department of Surgery, Division of Thoracic Surgery, G.B. Morgagni—L. Pierantoni Hospital, Via Carlo Forlanini n.34, 47121 Forlì, Italy; (S.M.); (S.S.); (D.A.); (F.S.)
| | - Desideria Argnani
- Department of Surgery, Division of Thoracic Surgery, G.B. Morgagni—L. Pierantoni Hospital, Via Carlo Forlanini n.34, 47121 Forlì, Italy; (S.M.); (S.S.); (D.A.); (F.S.)
| | - Franco Stella
- Department of Surgery, Division of Thoracic Surgery, G.B. Morgagni—L. Pierantoni Hospital, Via Carlo Forlanini n.34, 47121 Forlì, Italy; (S.M.); (S.S.); (D.A.); (F.S.)
- Department of Diagnostic and Specialty Medicine—DIMES of the Alma Mater Studiorum, Division of Thoracic Surgery, University of Bologna, G.B. Morgagni—L. Pierantoni Hospital, via Carlo Forlanini n. 34, 47121 Forlì, Italy
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7
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Monaco F, De Conti L, Vodret S, Zanotta N, Comar M, Manzotti S, Rubini C, Graciotti L, Fulgenzi G, Bovenzi M, Baralle M, Tomasetti M, Santarelli L. Force-feeding malignant mesothelioma stem-cell like with exosome-delivered miR-126 induces tumour cell killing. Transl Oncol 2022; 20:101400. [PMID: 35334283 PMCID: PMC8956928 DOI: 10.1016/j.tranon.2022.101400] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 03/11/2022] [Indexed: 11/28/2022] Open
Abstract
Exosome-enriched miR-126 (exo-miR) induced mass disaggregation of MPM-derived spheroids. Exo-miR plus the inhibitor of exosome release (GW4869) accumulated miR-126 within cells. Exo-miR plus GW4869 induced MPM-stem cell like death and in vivo tumour growth arrest. MiR-126 accumulated in cells induced a protective autophagy which was inhibited by GW4869. Exo-miR plus GW4869 induced a metabolic crisis, thus promoting necroptosis activation.
Malignant pleural mesothelioma (MPM) is an aggressive tumour resistant to treatments. It has been postulated that cancer stem cells (CSCs) persist in tumours causing relapse after multimodality treatment. In the present study, a novel miRNA-based therapy approach is proposed. MPM-derived spheroids have been treated with exosome-delivered miR-126 (exo-miR) and evaluated for their anticancer effect. The exo-miR treatment increased MPM stem-cell like stemness and inhibited cell proliferation. However, at a prolonged time, the up taken miR-126 was released by the cells themselves through exosomes; the inhibition of exosome release by an exosome release inhibitor GW4869 induced miR-126 intracellular accumulation leading to massive cell death and in vivo tumour growth arrest. Autophagy is involved in these processes; miR-126 accumulation induced a protective autophagy and the inhibition of this process by GW4869 generates a metabolic crisis that promotes necroptosis, which was associated with PARP-1 over-expression and cyt-c and AIF release. Here, for the first time, we proposed a therapy against CSCs, a heterogeneous cell population involved in cancer development and relapse.
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Affiliation(s)
- Federica Monaco
- Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy; Department of Excellence SBSP-Biomedical Sciences and Public Health, Polytechnic University of Marche, Ancona, Italy
| | - Laura De Conti
- RNA biology Group, International Centre for Genetic Engineering and Biotechnology (ICGEB), Trieste, Italy
| | - Simone Vodret
- Cardiovascular Biology Laboratory, International Centre for Genetic Engineering and Biotechnology (ICGEB), Trieste, Italy
| | - Nunzia Zanotta
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Manola Comar
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
| | - Sandra Manzotti
- Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Corrado Rubini
- Department of Excellence SBSP-Biomedical Sciences and Public Health, Polytechnic University of Marche, Ancona, Italy
| | - Laura Graciotti
- Department of Excellence SBSP-Biomedical Sciences and Public Health, Polytechnic University of Marche, Ancona, Italy
| | - Gianluca Fulgenzi
- Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Massimo Bovenzi
- Department of Medical Sciences, Clinical Unit of Occupational Medicine, University of Trieste, Trieste, Italy
| | - Marco Baralle
- RNA biology Group, International Centre for Genetic Engineering and Biotechnology (ICGEB), Trieste, Italy
| | - Marco Tomasetti
- Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy.
| | - Lory Santarelli
- Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
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8
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Surgical Management and Reconstruction of Diaphragm, Pericardium and Chest Wall in Mesothelioma Surgery: A Review. J Clin Med 2021; 10:jcm10112330. [PMID: 34073544 PMCID: PMC8197912 DOI: 10.3390/jcm10112330] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/20/2021] [Accepted: 05/25/2021] [Indexed: 12/12/2022] Open
Abstract
Mesothelioma is an aggressive disease arising from parietal pleura. Surgery is a valuable option in the frame of a multimodality treatment. Several surgical approaches have been standardized with the aim of a macroscopic complete resection; these often require homolateral diaphragm and pericardial resection and reconstruction. Extrapleural pneumonectomy (EPP) and extended pleurectomy decortication (EPD) have been recognized as radical surgical procedures. Nevertheless, both operations are technically challenging and associated with a significant rate of peri-operative morbidity and non-negligible mortality. The diaphragmatic and pericardial reconstruction technique is mandatory to avoid respiratory impairment and to reduce post-operative complications like gastric and cardiac herniation. Moreover, in the case of localized chest wall recurrence, surgery might be considered a valuable therapeutical option for highly selected and fit patients. All the technical aspects of the resection and reconstruction of the diaphragm, pericardium, and chest wall are described as well as the possible use of new minimally invasive techniques. In addition, the choice of different prosthetic materials, considering the most recent innovations in the field, are discussed.
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