Prolonged post‑recurrence survival following pleurectomy/decortication for malignant pleural mesothelioma

  • Authors:
    • Yuichiro Kai
    • Yasuhiro Tsutani
    • Norifumi Tsubokawa
    • Masaoki Ito
    • Takeshi Mimura
    • Yoshihiro Miyata
    • Morihito Okada
  • View Affiliations

  • Published online on: January 28, 2019     https://doi.org/10.3892/ol.2019.9979
  • Pages: 3607-3614
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Abstract

The present study analyzed surgical results in patients with malignant pleural mesothelioma (MPM) who underwent extrapleural pneumonectomy (EPP) or pleurectomy/decortication (P/D). Data for 44 patients who achieved macroscopic complete resection following neoadjuvant chemotherapy followed by EPP (n=29) or P/D (n=15) were reviewed. Patient demographics and oncological outcomes were compared between the EPP and P/D groups. The median overall (OS) and progression‑free survival (PFS) times were 22 and 14 months, respectively. OS was significantly different between the EPP and P/D groups (median OS, 17 vs. 34 months; 5‑year OS, 11 vs. 44%; P=0.019); no difference was noted in PFS (median PFS, 13 vs. 21 months; 5‑year PFS, 11 vs. 17%; P=0.373). Univariate analysis demonstrated that epithelial histology (P=0.0003) and P/D (P=0.018) were significant favorable prognostic factors for OS. Using multivariate analysis, epithelial histology (P=0.001) remained the only significant factor. Post‑recurrence survival (PRS) among all patients was significantly longer in the P/D group (median PRS, 3 vs. 20 months; 1.5‑year PRS, 5 vs. 54%; P=0.003), even among patients with epithelial‑type MPM (median PRS, 6 s vs. 20 months; 1.5‑year PRS, 8 vs. 61%; P=0.012). Chemotherapy following recurrence (P=0.033) was significantly associated with superior PRS in multivariate analysis. Postoperative pulmonary function was significantly improved in the P/D group. In summary, P/D may be an alternative procedure to EPP for resectable MPM providing similar PFS and improved PRS.
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March-2019
Volume 17 Issue 3

Print ISSN: 1792-1074
Online ISSN:1792-1082

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Spandidos Publications style
Kai Y, Tsutani Y, Tsubokawa N, Ito M, Mimura T, Miyata Y and Okada M: Prolonged post‑recurrence survival following pleurectomy/decortication for malignant pleural mesothelioma. Oncol Lett 17: 3607-3614, 2019
APA
Kai, Y., Tsutani, Y., Tsubokawa, N., Ito, M., Mimura, T., Miyata, Y., & Okada, M. (2019). Prolonged post‑recurrence survival following pleurectomy/decortication for malignant pleural mesothelioma. Oncology Letters, 17, 3607-3614. https://doi.org/10.3892/ol.2019.9979
MLA
Kai, Y., Tsutani, Y., Tsubokawa, N., Ito, M., Mimura, T., Miyata, Y., Okada, M."Prolonged post‑recurrence survival following pleurectomy/decortication for malignant pleural mesothelioma". Oncology Letters 17.3 (2019): 3607-3614.
Chicago
Kai, Y., Tsutani, Y., Tsubokawa, N., Ito, M., Mimura, T., Miyata, Y., Okada, M."Prolonged post‑recurrence survival following pleurectomy/decortication for malignant pleural mesothelioma". Oncology Letters 17, no. 3 (2019): 3607-3614. https://doi.org/10.3892/ol.2019.9979