{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T05:24:07Z","timestamp":1791869047651,"version":"4.3.4"},"reference-count":27,"publisher":"European Respiratory Society (ERS)","issue":"6","license":[{"start":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T00:00:00Z","timestamp":1717200000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011851","name":"Kom op tegen Kanker","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011851","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2024,4,3]]},"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The role of surgery in pleural mesothelioma remains controversial. It may be appropriate in highly selected patients as part of a multimodality treatment including chemotherapy. Recent years have seen a shift from extrapleural pleuropneumonectomy toward extended pleurectomy\/decortication. The most optimal sequence of surgery and chemotherapy remains unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>EORTC-1205-LCG was a multicentric, noncomparative phase 2 trial, 1:1 randomising between immediate (arm A) and deferred surgery (arm B), followed or preceded by chemotherapy. Eligible patients (Eastern Cooperative Oncology Group 0\u20131) had treatment-na\u00efve, borderline resectable T1\u20133 N0\u20131 M0 mesothelioma of any histology. Primary outcome was rate of success at 20\u2005weeks, a composite end-point including 1) successfully completing both treatments within 20\u2005weeks; 2) being alive with no signs of progressive disease; and 3) no residual grade 3\u20134 toxicity. Secondary end-points were toxicity, overall survival, progression-free survival and process indicators of surgical quality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>69 patients were included in this trial. 56 (81%) patients completed three cycles of chemotherapy and 58 (84%) patients underwent surgery. Of the 64 patients in the primary analysis, 21 out of 30 patients in arm A (70.0%; 80% CI 56.8\u201381.0%) and 17 out of 34 patients (50.0%; 80% CI 37.8\u201362.2%) in arm B reached the statistical end-point for rate of success. Median progression-free survival and overall survival were 10.8 (95% CI 8.5\u201317.2) months and 27.1 (95% CI 22.6\u201364.3) months in arm A, and 8.0 (95% CI 7.2\u201321.9) months and 33.8 (95% CI 23.8\u201344.6) months in arm B. Macroscopic complete resection was obtained in 82.8% of patients. 30- and 90-day mortality were both 1.7%. No new safety signals were found, but treatment-related morbidity was high.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>EORTC 1205 did not succeed in selecting a preferred sequence of pre- or post-operative chemotherapy. Either procedure is feasible with a low mortality, albeit consistent morbidity. A shared informed decision between surgeon and patient remains essential.<\/jats:p><\/jats:sec>","DOI":"10.1183\/13993003.02114-2023","type":"journal-article","created":{"date-parts":[[2024,6,6]],"date-time":"2024-06-06T15:55:20Z","timestamp":1717689320000},"page":"2302114","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":25,"title":["A randomised phase II study of extended pleurectomy\/decortication preceded or followed by chemotherapy in patients with early-stage pleural mesothelioma: EORTC 1205"],"prefix":"10.1183","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8029-4093","authenticated-orcid":false,"given":"Jo","family":"Raskin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veerle","family":"Surmont","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander 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