|
|
Mesothelioma Surgical Survival Survey
|
After twenty years of representing asbestos cancer patients, we know that
patients oftentimes are frustrated by the lack of understandable and
easy-to-find information that correlates treatment options, doctors and
survival. To help patients get answers, our firm has conducted a survey
among the nation's leading thoracic surgeons. We want to thank the surgeons
who have to date participated in this unprecedented effort to share data
directly with patients nationwide.
The following charts represent information we’ve received directly from
the participating surgeons. We have not edited the responses to our survey,
but have posted same "as is." If you are a surgeon, please click on this link
to access the survey, and fax it to us at 310-221-8095. We understand that
answers about a disease this complex may not neatly fit into the squares on
a survey chart. Doctors are encouraged to elucidate, elaborate, or include
additional information that you think is necessary for understanding your
approach to the disease. We will publish your comments verbatim and without
comment.
This is the first effort of its kind to survey meso specialists and bring
together comparative treatment data from the world’s best physicians. We
hope it will serve as a starting point for open and transparent comparisons.
Doctors are listed in the response chart alphabetically.
If you are a patient and do not see your surgeon listed, please ask your
surgeon to fill out the survey. This important data allows patients to
compare doctors, treatment regimens, and survival times. You can email
questions or comments to
info@rgwpc.com. If you would like, we will contact your doctor for you.
We are also developing a survey for oncologists and for those offering
alternative treatment protocols, and will post it soon on the web site.
Finally, the survey was originally published in Asbestos Magazine
(February 2008). Please click
here for the article.
|
Doctor |
Location |
Hospital |
# Mesos
Consult
Per/Yr |
# Mesos
Treated
Per/Yr |
Est.# of
Mesos
Treated
Career |
Est.# of
Depos
For
Mesos
2006 |
|
Robert Cameron a |
CA |
UCLA |
75 |
40 |
300 |
6 |
|
Raja Flores b |
NY |
Sloan Kettering |
60 |
50 |
450 |
0 |
|
David Harpole c |
NC |
Duke |
40-50 |
40-50 |
250+ |
1 |
|
Harvey Pass d |
NY |
NYU |
60 |
35-45 |
400-500 |
3 |
|
David Rice e |
TX |
M.D.
Anderson |
80 |
30 |
180 |
3 |
|
Larry Robinson f |
FL |
Moffit |
~20 |
~10 |
~120 |
2 |
|
Eric Vallières
g |
WA |
Swedish |
20 |
15 |
|
~5 |
|
Steven Wang
h |
MD |
Johns Hopkins |
30 |
20 |
100 |
2 |
|
Doctor |
EPP |
P/D |
TP |
Surg.
Mortality |
Pre-Op
Chemo |
Post-Op
Chemo/
Rad |
Median
Survival
(Months) |
|
Robert Cameron a |
N |
Y |
Y |
<1% |
N |
Y |
18-36 |
|
Raja
Flores b |
Y |
Y |
Y |
1% |
Not
Always |
Not
Always |
20 |
|
David Harpole c |
Y |
Y |
Y |
5% |
Y |
Preferred |
20-22
w/
trimodality |
|
Harvey Pass d |
150 |
100 |
N
|
5% [EPP]
1%
[PD]
2%
[All meso patients] |
Y
|
Y |
Stage dependent |
|
David Rice e |
Y |
Y |
N |
3% |
+/- |
Y |
Stage dependent |
|
Larry Robinson f |
Y |
Rare |
Y |
<3% |
N
|
Y |
Stage dependent |
|
Eric
Vallières
g |
Y |
Y -
Rare |
Y |
4% |
Y |
Rad. |
~24 |
|
Steven
Wang
h |
Y |
Y -
Rare |
Y |
1% |
Y |
Y |
Stage dependent |
|
“Always as advocate and treating physician,” Dr. Harpole
|
Footnotes |
|
a |
Surgical Criteria: Disease limited to predominantly epithelioid
histology in one hemithorax, adequate cardiac and pulmonary
function
Surgeon’s comments: “Each patient must be looked at
individually. Surgical procedure should be tailored to the
patients' functional status, extent of disease and type of meso.
And must take into consideration patients’ goals.”
|
|
b |
Surgical criteria: Able to accomplish a maximum cytoreduction
with a mortality <= 5%; independent of age and histology;
dependent on functional status.
Surgeon’s comments: “Survival rates are stage dependent.”
|
|
c |
Surgical criteria: [for EPP] epithelial or mixed histology
verified by Roggli; adequate PFT’s with differential
ventilation-perfusion scan; normal dobutamine echo without
evidence of pericardial involvement; mesothelioma protocol CT
with 3-D reconstruction; PET without distant disease; no
significant co-morbidity. [for PD] verified pathology, can
include sarcomatoid; either significant co-morbidity or T4
disease.
Surgeon’s comments: “Duke University sees most of the
mesothelioma cases in the southeastern U.S.”
|
|
d |
Surgical criteria: Stage I-II, (occasionally Stage III node
neg.), physiologically fit for surgery
|
|
e |
Surgical criteria: non-sarcomatoid; confined to ipsalateral
hemithorax; not N3; no trans-diaphragmatic involvement;
estimated post-pneumonectomy FEV ≥ 1.0 1/min/sec; cardiac status
healthy. Website:
www.mdanderson.org/diseases/mesothelioma.
Surgeon’s comments: “The above comments apply to extra-pleural
pneumonectomy, not pleurectomy. Comparing survival rates for
this disease is MEANINGLESS unless one compares stage-specific
survival.”
|
|
f |
Surgical criteria: Predominantly epithelial histology with
disease limited to the hemithorax and no obvious nodal
involvement. Website:
www.mychestsurgeon.com.
Surgeon’s comments: “With maintenance interferon therapy median
survival exceeds 3 years.”
|
|
g |
Surgical criteria: Fit, early stage, good cardiorespiratory
reserves
|
|
h |
Surgery Criteria: General good health, resectable disease, good
heart/lung function, response to chemotherapy
|
|
|
1 |
Review of 328 patients who underwent EPP, "Prevention, early
detection, and management of complications after 328 consecutive
extrapleural pneumonectomies," J Thorac Cardiovasc Surg. 2004
Jul;128(1):138-46
|
|
2 |
Review of tri-modal EPP in 183 patients, "Resection margins,
extrapleural nodal status, and cell type determine postoperative
long-term survival in trimodality therapy of malignant pleural
mesothelioma: results in 183 patients," J Thorac Cardiovasc Surg.
1999 Jan;117(1):54-63; discussion 63-5. Patients with
epithelial, margin-negative, extrapleural node-negative
resection had extended survival. |
*** POSTED ON FEBRUARY
7,
2008 ***
|
|
|
PATIENT PROFILES
