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Figure 1. Meta-analysis of reported short-term (perioperative and 30-day) mortality [38] .

[40]
A recent meta-analysis performed by Magouliotis et al. compiled a total of 1672 patients treated with EPP
and 2236 treated with P/D from 1990 to 2018. Compared to the 2.5 fold increase in short-term mortality
found by Taioli, they identified an OR of 3.24 in 30-day mortality among the EPP group. They also note a
significantly higher rate of postoperative atrial fibrillation, hemorrhage, empyema, bronchopleural fistula
[40]
and, - interestingly - air leak in the EPP group . While there were no significant differences in survival at
90 days or from 1-5 postoperative years, they found that overall median survival was significantly higher in
the P/D group . This finding, in particular, appears to suggest that the higher radicality of EPP does not
[40]
confer an oncologic advantage over P/D. The procedure not only carries a higher initial risk of major
complications and death, but life expectancy is also not greater in long-term survivors.