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Summary Report

Reviewer: James R. Jett, M.D., National Jewish Health, Denver, Colorado

The MesoVATS trial was a multicenter, open-label, randomized trial in the UK to evaluate treatment of malignant pleural mesothelioma. 175 patients were randomized to receive talc pleurodesis or video-assisted thoracoscopic partial pleurectomy (VAT-PP). The primary endpoint was one-year survival. The overall survival at one year was 52% in the VAT-PP and 57% in the talc pleurodesis group (HR 1.05 [95% CI 0.76-1.42]) p=0.81. Surgical complications, respiratory complications and air leak beyond 10 days were all more common in the VAT-PP group. Not all differences were statistically significant. The median hospital days was longer at seven days in the VAT-PP group compared to three days for those who received talc pleurodesis. VAT-PP is not recommended to improve overall survival in patients with pleural effusions due to malignant pleural mesothelioma.

Rintoul RC, Ritchie AJ, Edwards JG, et al. Efficacy and cost of video-assisted thoracoscopic partial pleurectomy versus talc pleurodesis in patients with malignant pleural mesothelioma (MesoVATS): An Open-label, randomized, controlled trial. www.thelancet.com published online June 16, 2014