{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T09:43:39Z","timestamp":1772012619624,"version":"3.50.1"},"reference-count":17,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T00:00:00Z","timestamp":1614729600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Surgery is a mainstay of treatment allowing for debulking of tumor and expansion of the lung for improvement in median survival and quality of life for patients with malignant pleural mesothelioma (MPM). Although optimal surgical technique remains open for debate\u2014extrapleural pneumonectomy (EPP) vs. pleurectomy\/decortication (P\/D)\u2014minimally invasive surgery (VATS-P\/D) remains underutilized in the management of MPM. We examined whether VATS-P\/D is a feasible alternative to EPP and P\/D. We evaluated the New York Statewide Planning and Research Cooperative System (SPARCS) from 2007\u20132017 to assess the short-term complications of EPP vs. P\/D, including a subanalysis of open P\/D vs. VATS-P\/D. There were 331 patients with open surgery; 269 with P\/D and 62 with EPP. There were 384 patients with P\/D; 269 were open and 115 VATS. Rates of any complication were similar between EPP and P\/D patients, but EPP had significantly higher rates of cardiovascular complications. After adjusting for confounders, those with a VATS approach were less likely to have any complication, compared to an open approach and significantly less likely to have a pulmonary complication. VATS-P\/D remains a viable alternative to radical surgery in MPM patients allowing for improved short-term outcomes.<\/jats:p>","DOI":"10.3390\/cancers13051068","type":"journal-article","created":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T05:10:16Z","timestamp":1614748216000},"page":"1068","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["VATS Pleurectomy Decortication Is a Reasonable Alternative for Higher Risk Patients in the Management of Malignant Pleural Mesothelioma: An Analysis of Short-Term Outcomes"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1545-4510","authenticated-orcid":false,"given":"Dong-Seok","family":"Lee","sequence":"first","affiliation":[{"name":"Thoracic Surgery Department, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY 10029, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Carollo","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Department, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY 10029, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naomi","family":"Alpert","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Department, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY 10029, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emanuela","family":"Taioli","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Department, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY 10029, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raja","family":"Flores","sequence":"additional","affiliation":[{"name":"Thoracic Surgery Department, Icahn School of Medicine at Mount Sinai, Mount Sinai Health System, New York, NY 10029, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Taioli, E., Wolf, A.S., Camacho-Rivera, M., Kaufman, A., Lee, D.S., Nicastri, D., Rosenzweig, K., and Flores, R.M. (2015). Determinants of survival in malignant pleural mesothelioma: A Surveillance, Epidemiology, and End Results (SEER) study of 14,228 patients. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0145039"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1016\/j.jtcvs.2007.10.054","article-title":"Extrapleural pneumonectomy versus pleurectomy\/decortication in the surgical management of malignant pleural mesothelioma: Results in 663 patients","volume":"135","author":"Flores","year":"2008","journal-title":"J. Thorac. Cardiovasc."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1178","DOI":"10.1002\/jso.25260","article-title":"Short-term outcomes of pleurectomy decortication and extrapleural pneumonectomy in mesothelioma","volume":"118","author":"Wolf","year":"2018","journal-title":"J. Surg. Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1016\/j.athoracsur.2014.09.056","article-title":"Meta-analysis of survival after pleurectomy decortication versus extrapleural pneumonectomy in mesothelioma","volume":"99","author":"Taoili","year":"2015","journal-title":"Ann. Thorac. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1007\/s11748-018-1027-6","article-title":"Updated meta-analysis of survival after extrapleural pneumonectomy versus pleurectomy\/decortication in mesothelioma","volume":"67","author":"Magouliotis","year":"2019","journal-title":"Gen. Thorac. Cardiovasc. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.jtcvs.2014.03.011","article-title":"Malignant pleural mesothelioma and the Society of Thoracic Surgeons Database: An analysis of surgical morbidity and mortality","volume":"148","author":"Burt","year":"2014","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/j.lungcan.2011.12.009","article-title":"Extrapleural pneumonectomy for early stage malignant pleural mesothelioma: A harmful procedure","volume":"77","author":"Rena","year":"2012","journal-title":"Lung Cancer"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Schwartz, R.M., Lieberman-Cribbin, W., Wolf, A., Flores, R.M., and Taioli, E. (2018). Systematic review of quality of life following pleurectomy decortication and extrapleural pneumonectomy for malignant pleural mesothelioma. BMC Cancer, 18.","DOI":"10.1186\/s12885-018-5064-4"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2008","DOI":"10.1016\/j.athoracsur.2008.07.009","article-title":"Surgery for early-stage non-small cell lung cancer: A systematic review of the video-assisted thoracoscopic surgery versus thoracotomy approaches to lobectomy","volume":"86","author":"Whitson","year":"2008","journal-title":"Ann. Thorac. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1093\/ejcts\/ezt051","article-title":"Long-term survival in video-assisted thoracoscopic lobectomy versus open lobectomy in lung-cancer patients: A meta-analysis","volume":"44","author":"Taioli","year":"2013","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1097\/00005650-199801000-00004","article-title":"Comorbidity measures for use with administrative data","volume":"36","author":"Elixhauser","year":"1998","journal-title":"Med. Care"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1016\/S1010-7940(01)00995-2","article-title":"Palliative surgical debulking in malignant mesothelioma. Predictors of survival and symptom control","volume":"20","author":"Edwards","year":"2001","journal-title":"Eur. J. Cardio Thorac. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1118","DOI":"10.1016\/S0140-6736(14)60418-9","article-title":"Efficacy and cost of video-assisted thoracoscopic partial pleurectomy versus talc pleurodesis in patients with malignant pleural mesothelioma (MesoVATS): An open-label, randomised, controlled trial","volume":"384","author":"Rintoul","year":"2014","journal-title":"Lancet"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e000368","DOI":"10.1136\/bmjresp-2018-000368","article-title":"MesoTRAP: A feasibility study that includes a pilot clinical trial comparing video-assisted thoracoscopic partial pleurectomy decortication with indwelling pleural catheter in patients with trapped lung due to malignant pleural mesothelioma designed to address recruitment and randomisation uncertainties and sample size requirements for a phase III trial","volume":"6","author":"Matthews","year":"2019","journal-title":"BMJ Open Respir. Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1016\/j.ejso.2004.08.014","article-title":"Improved survival with VATS pleurectomy-decortication in advanced malignant mesothelioma","volume":"31","author":"Halstead","year":"2005","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1016\/S0022-5223(98)70274-0","article-title":"Preoperative tumour volume is associated with outcome in malignant pleural mesothelioma","volume":"115","author":"Pass","year":"1998","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.ejcts.2007.09.039","article-title":"The role of video-assisted thoracoscopic pleurectomy\/decortication in the therapeutic management of malignant pleural mesothelioma","volume":"33","author":"Nakas","year":"2008","journal-title":"Eur. J. Cardio Thorac. Surg."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/13\/5\/1068\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:31:49Z","timestamp":1760160709000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/13\/5\/1068"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,3]]},"references-count":17,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,3]]}},"alternative-id":["cancers13051068"],"URL":"https:\/\/doi.org\/10.3390\/cancers13051068","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,3]]}}}