| In recent years, the incidence of malignant pleural mesothelioma (MPM) has increased in China and other countries, especially in UK. More and more young people suffered with lung cancer. So the treatment for both diseases has been emphasized increasingly. extrapleural pneumonectomy (EPP) is an extensive radical operation for MPM and lung cancer, which includes en bloc resection of ipsilateral lung, pleura, diaphragmatic muscle and pericardium for the utmost excision of carcinoma. The retrospective study showed the good effect of this kind of operation on MPM and IIb or III lung cancer. But as we know, EPP is a high-risk operation as pneumonectomy. In this study, 11 cases underwent extrapleural pneumonectomy were analyzed retrospectively from 1984 to 2004 in our department, 30-day and 60-day operative mortality were assessed respectively, postoperative long-term survival and risk factors were also evaluated. The purpose of this study was to understand the operative risk and therapeutic efficacy of EPP primarily which may be helpful for the further study. In this group, 9 cases were lung cancer including 1 recurring case and 1 metastatic case, the other two were MPM; 6 cases were male, 4 cases were female and 1 case was not clear in gender; the age ranged from 36~62 years old, the average of age was 51.6 years; 9 cases underwent left lateral operation and 2 cases underwent right lateral operation. There was 1 death case, the oldest patient in this group that was 62 years old and dead of cardiorespiratory dysfunction. The 60-day operative mortality was 9.1%, close to pneumonectomy (3-25%). There was no significant difference of operative mortality in sex, age, the extent of operation and the side of EPP. The data indicated that the age did not influence the EPP risk, maybe due to relative young group and small sample. Some researches reported that the right operation was more dangerous than left one, but in this study, two operations had same risk maybe due to only two right EPP. The 1-and 2-year survival rate was 54.5% and 27.3% respectively. The 1-and 2-year survival rate of 9 lung cancer cases was 44.4%(4/9) and 22.2% (2/9) respectively , better than the results from Shimizu J (10 cases,1 year survival rate was 20%) but worse than Dobashi K's report (12cases, 1-and 3-year survival rate was 52% and 26% respectively). The 1-and 2-year survival rate of 2 MPM cases was 100 %( 2/2) and 50 %( 1/2), similar to Sugarbaker'study in which the 2-and 5-year survival rate was 45% and 22% respectively. 5 cases survived up to now and 1 case has been surviving for 4 years, but there has not been a 5-year survivor. In this study, 4 cases had pleural effusion, but only one case surviving 8 month to this day had cytological diagnosis, another case has been surviving 4 years up to now. 3 lung cancer cases were in N2 stage in which one cases have...
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