Survival Effect of Complete Multimodal Therapy in Malignant Pleural Mesothelioma

• Published in: Journal of chest surgery 2022-10, Vol.55 (5), p.405-412
• Main Authors: Sayan, Muhammet, Bas, Aynur, Turk, Merve Satir, Ozkan, Dilvin, Celik, Ali, Kurul, İsmail Cuneyt, Tastepe, Abdullah Irfan
• Format: Article
• Language: English
• Subjects: Clinical Research; extrapleural pneumonectomy; mesothelioma; pleura; pneumonectomy
• ISSN: 2765-1606; 2765-1614
• DOI: 10.5090/jcs.22.037

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.