{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T05:30:42Z","timestamp":1771479042426,"version":"3.50.1"},"reference-count":14,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2022,6,15]],"date-time":"2022-06-15T00:00:00Z","timestamp":1655251200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Sarcoma can present as locally advanced disease involving pleura for which extra-pleural pneumonectomy (EPP) may be the only surgical option to ensure adequate local control. Data were collected on patients who underwent EPP between January 2009 and August 2021 at Princess Margret Hospital and SickKids (Toronto) using the CanSaRCC (Canadian Sarcoma Research and Clinical Collaboration). Ten patients with locally advanced sarcoma involving the pleura, aged 4 to 59 years (median 19.5 years) underwent EPP. Nine (90%) received pre-operative chemotherapy and eight (80%) achieved an R0 resection. Hemithoracic radiation was administered preoperatively (n = 6, 60%) or postoperatively (n = 4, 40%). Five (50%) patients were alive without disease at last follow-up (median 34.2 months) and time from EPP to last FU was median 29.2 months (range 2.2\u201387.5). Two patients (20%) had local recurrence, 4.3 and 5.8 months from EPP, and both died from progressive disease, 13.1 and 8.2 months from EPP, respectively. One patient died from brain metastasis (17 months), one died from radiation associated osteosarcoma (66 months), and one died from surgical complications (heart failure from constrictive pericarditis). EPP offers a feasible and life-prolonging surgical consideration for patients with locally advanced sarcoma involving the pleura in combination with chemotherapy and radiation. Consequently, EPP should be considered during multi-disciplinary tumor board discussions at high-volume centers.<\/jats:p>","DOI":"10.3390\/curroncol29060340","type":"journal-article","created":{"date-parts":[[2022,6,15]],"date-time":"2022-06-15T01:39:54Z","timestamp":1655257194000},"page":"4260-4266","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Extra-Pleural Pneumonectomy (EPP) in Children and Adults with Locally Advanced Sarcoma: A CanSaRCC Study"],"prefix":"10.3390","volume":"29","author":[{"given":"Caroline","family":"Rodrigues","sequence":"first","affiliation":[{"name":"Division of Medical Oncology, Canadian Sarcoma Research and Clinical Collaboration (CanSaRCC), Princess Margaret Cancer Centre\u2014University Health Network, Toronto, ON M5G 2C1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hagit","family":"Peretz Soroka","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Canadian Sarcoma Research and Clinical Collaboration (CanSaRCC), Princess Margaret Cancer Centre\u2014University Health Network, Toronto, ON M5G 2C1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agostino","family":"Pierro","sequence":"additional","affiliation":[{"name":"Division of General Surgery, Hospital for Sick Children, University of Toronto, Toronto, ON M5G 1X8, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6284-1994","authenticated-orcid":false,"given":"Reto M.","family":"Baertschiger","sequence":"additional","affiliation":[{"name":"Division of General Surgery, Hospital for Sick Children, University of Toronto, Toronto, ON M5G 1X8, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcelo","family":"Cypel","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Toronto General Hospital\u2014University Health Network, University of Toronto, Toronto, ON M5G 2C1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Donahoe","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Toronto General Hospital\u2014University Health Network, University of Toronto, Toronto, ON M5G 2C1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9762-6901","authenticated-orcid":false,"given":"Derek S.","family":"Tsang","sequence":"additional","affiliation":[{"name":"Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON M5G 2C1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Cho","sequence":"additional","affiliation":[{"name":"Radiation Medicine Program, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON M5G 2C1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2000-9427","authenticated-orcid":false,"given":"Marc","family":"De Perrot","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Toronto General Hospital\u2014University Health Network, University of Toronto, Toronto, ON M5G 2C1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas K.","family":"Waddell","sequence":"additional","affiliation":[{"name":"Division of Thoracic Surgery, Toronto General Hospital\u2014University Health Network, University of Toronto, Toronto, ON M5G 2C1, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abha A.","family":"Gupta","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Canadian Sarcoma Research and Clinical Collaboration (CanSaRCC), Princess Margaret Cancer Centre\u2014University Health Network, Toronto, ON M5G 2C1, Canada"},{"name":"Division of Hematology\/Oncology, Hospital for Sick Children, University of Toronto, Toronto, ON M5G 1X8, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1255","DOI":"10.1007\/s00270-019-02259-w","article-title":"Basic Knowledge in Soft Tissue Sarcoma","volume":"42","author":"Bourcier","year":"2019","journal-title":"CardioVasc. Interv. Radiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"6","DOI":"10.3747\/co.27.5481","article-title":"Systemic therapy in pediatric-type soft-tissue sarcoma","volume":"27","author":"Ingley","year":"2020","journal-title":"Curr. Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.21037\/jtd.2019.02.61","article-title":"Extra-pleural pneumonectomy","volume":"11","author":"Duranti","year":"2019","journal-title":"J. Thorac. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Hameury, F., Marec-Berard, P., Eymery, M., Wijnen, M.H.W., van der Kaaij, N., Mure, P.Y., Tronc, F., Chotel, F., Libbrecht, C., and van Boven, W.J.P. (2021). Pleuropneumonectomy as salvage therapy in children suffering from primary or metastatic sarcomas with pleural localizations. Cancers, 13.","DOI":"10.3390\/cancers13153655"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1136\/thx.4.4.173","article-title":"Extrapleural pneumonectomy and pleurectomy in pulmonary tuberculosis","volume":"4","author":"Sarot","year":"1949","journal-title":"Thorax"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1136\/thx.31.1.15","article-title":"Pleuropneumonectomy in the management of diffuse malignant mesothelioma of the pleura Experience with 29 patients","volume":"31","author":"Butchart","year":"1976","journal-title":"Thorax"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1002\/jso.25979","article-title":"Multimodality treatment including surgery for primary pulmonary sarcoma: Size does matter","volume":"122","author":"Collaud","year":"2020","journal-title":"J. Surg. Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1016\/S1470-2045(11)70149-8","article-title":"Extra-pleural pneumonectomy versus no extra-pleural pneumonectomy for patients with malignant pleural mesothelioma: Clinical outcomes of the Mesothelioma and Radical Surgery (MARS) randomised feasibility study","volume":"12","author":"Treasure","year":"2011","journal-title":"Lancet Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1016\/S1470-2045(20)30606-9","article-title":"Surgery for malignant pleural mesothelioma after radiotherapy (SMART): Final results from a single-centre, phase 2 trial","volume":"22","author":"Cho","year":"2021","journal-title":"Lancet Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1111\/j.1759-7714.2010.00019.x","article-title":"Primary monophasic synovial sarcoma of the pleura: Neoadjuvant chemotherapy followed by complete resection","volume":"1","author":"Silva","year":"2010","journal-title":"Thorac. Cancer"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.clinimag.2005.07.001","article-title":"A case of pulmonary synovial sarcoma diagnosed with detection of chimera gene: Imaging findings","volume":"30","author":"Matsuo","year":"2006","journal-title":"Clin. Imaging"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"200329","DOI":"10.1016\/j.ehpc.2019.200329","article-title":"Two cases of poorly differentiated synovial sarcoma arising from the chest wall\u2014One case of Ewing sarcoma-like small cell type with death 4 years after the first presentation and one case of high-grade spindle cell type receiving postoperative adjuvant chemotherapy","volume":"18","author":"Matsuo","year":"2019","journal-title":"Hum. Pathol. Case Rep."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1893","DOI":"10.1016\/j.athoracsur.2014.12.092","article-title":"Extensive surgical treatment of primary pulmonary synovial sarcoma after recurrent pneumothorax","volume":"100","author":"Petrosyan","year":"2015","journal-title":"Ann. Thorac. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1738","DOI":"10.1016\/j.jpedsurg.2006.05.063","article-title":"Extrapleural pneumonectomy in children","volume":"41","author":"Flores","year":"2006","journal-title":"J. Pediatric Surg."}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/29\/6\/340\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:31:43Z","timestamp":1760139103000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/29\/6\/340"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,15]]},"references-count":14,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,6]]}},"alternative-id":["curroncol29060340"],"URL":"https:\/\/doi.org\/10.3390\/curroncol29060340","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,15]]}}}