O-135IMPACT OF INDUCTION THERAPY ON POSTOPERATIVE OUTCOME AFTER EXTRAPLEURAL PNEUMONECTOMY FOR MALIGNANT PLEURAL MESOTHELIOMA: DOES INDUCTION ACCELERATED HEMITHORACIC RADIATION INCREASE THE SURGICAL RISK?
Bibliographic record
Abstract
Objectives: Patients with malignant pleural mesothelioma (MPM) eligible to extrapleural pneumonectomy (EPP) may benefit from induction chemotherapy (CT) as historically described, or from induction accelerated hemithoracic intensity-modulated radiation therapy (IMRT) as a potential alternative. However, the impact of the type of induction therapy on postoperative morbidity and mortality remains unknown. Methods: We set a retrospective study including every patient who underwent EPP for MPM in our institution between January 2001 and June 2014 (study group). Patients without induction treatment (n = 7) or undergoing induction CT and IMRT (n = 2) were then excluded, the remaining patients being divided according to the type of induction treatment in group 1-CT and group 2-IMRT. Results: All together, 127 patients (mean age 60.9 ± 9.3 years, male 82.6%, right side 59.0%) underwent EPP for MPM during the study period with an in-hospital mortality of 4% (n = 5). The histology was epithelioid in 94 (74.0%) and biphasic in 31 (24.4%) patients. The pathologic stage was III in 65 (51.1%) and IV in 50 (39.3%) patients. From this study group, 64 patients were included in group 1-CT and 54 patients were included in group 2-IMRT. As compared to group 1-CT, group 2-IMRT was characterized by older patients (59.37 ± 9.23 vs 63.1 ± 8.46 years, P = 0.0218), more right-sided resections (46.8% vs 77.7%, P = 0.0011), more advanced disease (pathologic stage IV: 28.1% vs 55.5%, P = 0.0145), less red blood cells transfusions (4.9 ± 3.2 vs 2.7 ± 2.5 packs, P < 0.001), less plasma or platelets transfusions (31.2% vs 5.5%, P = 0.0072) and similar rate of major complications (29.6% vs 37.9%, P = 0.5162). The in-hospital mortality rate was 6.25% in group 1-CT (n = 4) and null in group 2-RT (P = 0.1743). Conclusions: In this large monocentric series of EPP for MPM, the recent switch from induction CT to induction IMRT allowed the resection of older patients with more advanced tumours, less transfusion requirements, comparable postoperative morbidity and no postoperative mortality. Disclosure: No significant relationships.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".