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Lindenmann, J; Matzi, V; Neuboeck, N; Anegg, U; Maier, A; Smolle, J; Smolle-Juettner, FM.
Multimodal therapy of malignant pleural mesothelioma: is the replacement of radical surgery imminent?
Interact Cardiovasc Thorac Surg. 2013; 16(3):237-243
Doi: 10.1093/icvts/ivs465
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- Leading authors Med Uni Graz
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Lindenmann Jörg
- Co-authors Med Uni Graz
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Anegg Udo
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Fink-Neuböck Nicole
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Maier Alfred
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Matzi Veronika
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Smolle Josef
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Smolle-Juettner Freyja-Maria
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- Abstract:
- Malignant pleural mesothelioma (MPM) remains an aggressive thoracic malignancy associated with poor prognosis. There is no standard treatment regimen, and particularly, the impact of radical surgery remains controversial. The main goal of our retrospective single-centre study was to evaluate the surgical and non-surgical treatment modalities applied at our division regarding their effect on the patient's survival. During the last decade, 82 patients with histologically confirmed MPM were treated at our division. The complete clinical records of 61 patients were eligible for statistical evaluation. There were 14 women (23%) and 47 men (77%) with a mean age of 63.7 years. Epitheloid subtype was found in 48 patients (78.7%), sarcomatoid in 3 (4.9%) and biphasic in 10 (16%). Surgery as the first treatment modality was performed in 44 patients (72.1%). Pleurectomy/decortication was done in 28 cases (45.9%), extended pleurectomy/decortication was performed in 13 (21.3%) and extrapleural pneumonectomy in 3 (4.9%). Additional intraoperative photodynamic therapy was administered in 20 patients, 34 underwent chemotherapy (55.7%) and 12 had radiotherapy (19.7%). Mean survival time for the collective was 18.3 months. Five-year survival was 17% in the epitheloid histology group, where patients treated with chemotherapy alone yielded a significant increase in survival (P = 0.049), and those with other subtypes survived for a maximum of 20.6 months. Chemotherapy and pleurectomy/decortication can extend the survival time of patients with MPM remarkably. The adequate treatment options have to be tailored to the specific particular needs of each patient considering histological subtype, tumour stage and patient's individual functional assessment as well as comorbidity.
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Adult -
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Aged -
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Aged, 80 and over -
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Aged, 80 and over -
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Chemotherapy, Adjuvant -
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Chi-Square Distribution -
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Comorbidity -
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Female -
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Health Status -
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Humans -
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Kaplan-Meier Estimate -
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Male -
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Mesothelioma - mortality Mesothelioma - pathology Mesothelioma - surgery Mesothelioma - therapy
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Middle Aged -
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Neoplasm Staging -
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Palliative Care -
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Patient Selection -
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Photochemotherapy -
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Pleural Neoplasms - mortality Pleural Neoplasms - pathology Pleural Neoplasms - surgery Pleural Neoplasms - therapy
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Propensity Score -
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Radiotherapy, Adjuvant -
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Retrospective Studies -
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Thoracic Surgical Procedures - adverse effects Thoracic Surgical Procedures - mortality
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Time Factors -
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Treatment Outcome -
- Find related publications in this database (Keywords)
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Mesothelioma
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Pleural disease
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Palliative care
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Thoracic surgery