Abstract：
Malignant pleural mesothelioma (MPM) is an aggressive asbestos-related tumour with poor prognosis. To date, a multimodality treatment, including chemotherapy and surgery, with or without radiotherapy, is the gold standard therapy for selected patients with epithelioid and early-stage MPM. In this setting, the goal of surgery is to achieve the macroscopic complete resection, obtained by either extrapleural pneumonectomy or pleurectomy/decortication. Failure, in local and/or distant sites, is one of the major concerns; in fact, there has been no established treatment for the recurrence of MPM after the multimodal approach, and the role of surgery in this context is still controversial. By using electronic databases, studies that included recurrent MPM patients who underwent a second surgery were identified. The endpoints included were: a pattern of recurrence, post-recurrence survival (PRS), and the type of second surgery. When available, factors predicting better PRS and perioperative mortality and morbidity were collected. This systematic review offers an overview of the results that are currently obtained in patients undergoing a second surgery for relapsed MPM, with the aim to provide a comprehensive view on this subject that explores if a second surgery leads to an improvement in survival.
摘要：
恶性胸膜间皮瘤（MPM）是一种侵袭性石棉相关肿瘤，预后不良。迄今为止,多模态治疗,包括化疗和手术,有或没有放射治疗，是选定的上皮样和早期MPM患者的黄金标准疗法。在此设置中，手术的目标是实现宏观的完全切除，通过胸膜外肺切除术或胸膜切除术/剥脱术获得。失败,在本地和/或遥远的地点，是主要问题之一；事实上，在多模式方法后，尚未确定MPM复发的治疗方法，手术在这种情况下的作用仍然存在争议。通过使用电子数据库，纳入接受二次手术的复发性MPM患者的研究被确定.终点包括：复发模式，复发后生存率（PRS），以及第二次手术的类型。如果可用,收集预测更好的PRS和围手术期死亡率和发病率的因素。本系统综述提供了目前在接受第二次手术治疗复发性MPM的患者中获得的结果的概述。目的是提供关于这个问题的全面观点，探讨第二次手术是否会提高生存率。
