{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T01:05:39Z","timestamp":1778807139215,"version":"3.51.4"},"reference-count":11,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T00:00:00Z","timestamp":1713225600000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2024,4]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Extrapleural pneumonectomy (EPP) is a complex surgical procedure involving en\u2010bloc resection of the parietal and visceral pleura, lung, pericardium, and ipsilateral diaphragm. Small case series of pleural\u2010based sarcoma of predominantly pediatric patients suggest EPP may be a life\u2010prolonging surgical option. We aimed to describe the characteristics and outcomes of adults who underwent EPP at a specialized sarcoma center.<\/jats:p><\/jats:sec>Methods<\/jats:title>Clinicopathologic variables, surgical details, and follow\u2010up information were extracted for patients undergoing EPP for pleural\u2010based sarcoma between August 2017 and December 2020. Primary outcomes were event\u2010free survival (EFS) and overall survival (OS) from the date of EPP. Secondary outcomes were disease\u2010free interval (DFI) prior to EPP, and early and late postoperative complications.<\/jats:p><\/jats:sec>Results<\/jats:title>Eight patients were identified, seven with soft tissue sarcoma and one with bone sarcoma. Patients had either localized disease with a primary thoracic sarcoma, sarcoma recurrent to the thorax, or de novo metastatic disease. All patients underwent resection of their pleural\u2010based sarcoma by an experienced cardiothoracic surgeon, and some patients had pre or postoperative treatment. The perioperative morbidity was comparable with previously published reports of EPP performed in mesothelioma patients. At median follow\u2010up of 22.5\u2009months, median EFS was 6.0\u2009months and OS was 20.7\u2009months. Six patients (75%) had disease recurrence; five (62.5%) died of progressive disease. Two patients (25%) had not recurred: one died of a radiation\u2010related esophageal rupture, and one was alive with no evidence of disease at 37.0\u2009months. Characteristics of those with the longest EFS included low\u2010grade histology and achieving a metabolic response to preoperative chemotherapy.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>In adults with pleural\u2010based sarcoma, EPP is rarely curative but appears to be a feasible salvage procedure when performed at specialized centers. Patient selection is critical with strong consideration given to multimodal therapy to optimize patient outcomes. In the absence of a confirmed response to neoadjuvant treatment, long term survival is poor and EPP should not be recommended.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cnr2.2065","type":"journal-article","created":{"date-parts":[[2024,4,17]],"date-time":"2024-04-17T04:15:17Z","timestamp":1713327317000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Extrapleural pneumonectomy for sarcoma: Outcomes of adult patients at a specialized center"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9373-6559","authenticated-orcid":false,"given":"Betty Y.","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Medical Oncology Chris O'Brien Lifehouse Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashley R.","family":"Wilson\u2010Smith","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia"},{"name":"Department of Cardiothoracic Surgery Royal Prince Alfred Hospital Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5579-3728","authenticated-orcid":false,"given":"Elizabeth A.","family":"Connolly","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Chris O'Brien Lifehouse Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5516-2619","authenticated-orcid":false,"given":"Madeleine C.","family":"Strach","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Chris O'Brien Lifehouse Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan","family":"Ussher","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia"},{"name":"Department of Cardiothoracic Surgery Royal Prince Alfred Hospital Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tristan","family":"Yan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia"},{"name":"Department of Cardiothoracic Surgery Royal Prince Alfred Hospital Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vivek A.","family":"Bhadri","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Chris O'Brien Lifehouse Sydney New South Wales Australia"},{"name":"Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,4,16]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.3137"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-7940(00)00465-6"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.25979"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2019.02.61"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.31.1.15"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.4.4.173"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol29060340"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13153655"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/030089160008600511"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2006.05.063"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0b013e3181ed0489"}],"container-title":["Cancer Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cnr2.2065","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,26]],"date-time":"2024-04-26T03:34:51Z","timestamp":1714102491000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/cnr2.2065"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4]]},"references-count":11,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1002\/cnr2.2065"],"URL":"https:\/\/doi.org\/10.1002\/cnr2.2065","archive":["Portico"],"relation":{},"ISSN":["2573-8348","2573-8348"],"issn-type":[{"value":"2573-8348","type":"print"},{"value":"2573-8348","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4]]},"assertion":[{"value":"2023-08-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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