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J Chest Surg

Published online September 7, 2022

Copyright © Journal of Chest Surgery.

Survival Effect of Complete Multimodal Therapy in Malignant Pleural Mesothelioma

Muhammet Sayan, M.D. 1, Aynur Bas, M.D. 2, Merve Satir Turk, M.D. 1, Dilvin Ozkan, M.D. 1, Ali Celik, M.D. 1, İsmail Cuneyt Kurul, M.D. 1, Abdullah Irfan Tastepe, M.D. 1

1Department of Thoracic Surgery, Gazi University, Ankara; 2Division of Thoracic Surgery, Basaksehir Cam Sakura City Hospital, Istanbul, Turkey

Correspondence to:Muhammet Sayan
Tel 90-5071927600
Fax 90-3122025890
E-mail muhammets@gazi.edu.tr
ORCID
https://orcid.org/0000-0002-5402-9031

Received: May 18, 2022; Revised: July 8, 2022; Accepted: July 28, 2022

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Malignant pleural mesothelioma (MPM) is an aggressive pleural malignancy, and despite all multimodal treatment modalities, the 5-year overall survival rate of patients with MPM is less than 20%. In the present study, we aimed to analyze the surgical and prognostic outcomes of patients with MPM who received multimodal treatment.
Methods: In this retrospective, single-center study, the records of patients who underwent surgery for MPM between January 2010 and December 2020 at our department were reviewed retrospectively.
Results: Sixty-four patients were included in the study, of whom 23 (35.9%) were women and 41 (64.1%) were men. Extrapleural pneumonectomy, pleurectomy/decortication, and extended pleurectomy/decortication procedures were performed in 34.4%, 45.3%, and 20.3% of patients, respectively. The median survival of patients was 21 months, and the 5-year survival rate was 20.2%. Advanced tumor stage (hazard ratio [HR], 1.8; p=0.04), right-sided extrapleural pneumonectomy (HR, 3.1; p=0.02), lymph node metastasis (HR, 1.8; p=0.04), and incomplete multimodal therapy (HR, 1.9; p=0.03) were poor prognostic factors. There was no significant survival difference according to surgical type or histopathological subtype.
Conclusion: Multimodal therapy can offer an acceptable survival rate in patients with MPM. Despite its poor reputation in the literature, the survival rate after extrapleural pneumonectomy, especially left-sided, was not as poor as might be expected.

Keywords: Mesothelioma, Pneumonectomy, Pleura, Extrapleural pneumonectomy

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J Chest Surg

Published online September 7, 2022

Copyright © Journal of Chest Surgery.

Survival Effect of Complete Multimodal Therapy in Malignant Pleural Mesothelioma

Muhammet Sayan, M.D. 1, Aynur Bas, M.D. 2, Merve Satir Turk, M.D. 1, Dilvin Ozkan, M.D. 1, Ali Celik, M.D. 1, İsmail Cuneyt Kurul, M.D. 1, Abdullah Irfan Tastepe, M.D. 1

1Department of Thoracic Surgery, Gazi University, Ankara; 2Division of Thoracic Surgery, Basaksehir Cam Sakura City Hospital, Istanbul, Turkey

Correspondence to:Muhammet Sayan
Tel 90-5071927600
Fax 90-3122025890
E-mail muhammets@gazi.edu.tr
ORCID
https://orcid.org/0000-0002-5402-9031

Received: May 18, 2022; Revised: July 8, 2022; Accepted: July 28, 2022

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Malignant pleural mesothelioma (MPM) is an aggressive pleural malignancy, and despite all multimodal treatment modalities, the 5-year overall survival rate of patients with MPM is less than 20%. In the present study, we aimed to analyze the surgical and prognostic outcomes of patients with MPM who received multimodal treatment.
Methods: In this retrospective, single-center study, the records of patients who underwent surgery for MPM between January 2010 and December 2020 at our department were reviewed retrospectively.
Results: Sixty-four patients were included in the study, of whom 23 (35.9%) were women and 41 (64.1%) were men. Extrapleural pneumonectomy, pleurectomy/decortication, and extended pleurectomy/decortication procedures were performed in 34.4%, 45.3%, and 20.3% of patients, respectively. The median survival of patients was 21 months, and the 5-year survival rate was 20.2%. Advanced tumor stage (hazard ratio [HR], 1.8; p=0.04), right-sided extrapleural pneumonectomy (HR, 3.1; p=0.02), lymph node metastasis (HR, 1.8; p=0.04), and incomplete multimodal therapy (HR, 1.9; p=0.03) were poor prognostic factors. There was no significant survival difference according to surgical type or histopathological subtype.
Conclusion: Multimodal therapy can offer an acceptable survival rate in patients with MPM. Despite its poor reputation in the literature, the survival rate after extrapleural pneumonectomy, especially left-sided, was not as poor as might be expected.

Keywords: Mesothelioma, Pneumonectomy, Pleura, Extrapleural pneumonectomy

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