Author of

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  O22 - Mesothelioma III (ID 122)

  • Event: WCLC 2013
  • Type: Oral Abstract Session
  • Track: Mesothelioma
  • Presentations: 1
  • Moderators:P. Baas, R. Gaafar
  • Coordinates: 10/29/2013, 16:15 - 17:45, Bayside Gallery A, Level 1

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    O22.06 - Quality of Life Measurement Parallel Changes in Pulmonary Function in Patients Undergoing Pleurectomy and Decortication for Malignant Pleural Mesothelioma (ID 3444)

    17:10 - 17:20  |  Author(s): K. Todd
    • Abstract
    • Presentation
    • Slides

    Background
    The role of maximal cyto-reductive surgery in malignant pleural mesothelioma (MPM) remains controversial. Although selected patients achieve long-term disease control following extended pleurectomy and decortication (PD), not all patients benefit. In addition surgical complications and side effects may adversely affect quality of life (QoL). We previously observed significant improvement in the quality of life following PD in patients who were symptomatic at baseline (Mollberg et al, Ann Thorac Surg 2012). In this study, we further examined the effects of PD on pulmonary function and correlated changes in pulmonary function with QOL.

    Methods
    Consecutive patients with MPM undergoing PD were prospectively enrolled at a single center. The primary endpoint was to determine the effects of PD on QoL. Health related QoL was assessed using the European Organization for Research and Treatment of Cancer Core Quality of Life Questionaire-C30 (EORTC QLQ-C30) before operation and at one,4-5, 7-8 , 10-11 and 12-13monthsmonths postoperatively. Pulmonary function testing was performed (PFTs) were measured immediately before the operation and at 6-7 months postoperatively. Patients were grouped according to the World Health Organization baseline performance status (PS) and compared.

    Results
    Twenty-seven patients with a median age of 71 years old (range 59 to 91 years), 19 males and 8 females, were enrolled in the study from March 2010 to October 2012. At the time of the operation, 17 patients were WHO PS 0, 10 were PS 1. At baseline, the PS 1 patients had a significantly worse global QoL (p<.0001), functional (p<0.0001) and symptoms scores (p<0.0001). PS 0 patients had not significant change in global QoL or functional) and symptoms scores (except for emotional function and insomnia p<0.01) following the operation. In addition they demonstrated a significant decrease in FVC (p<0.003), FEV1 (p<0.005), TLC (<0.001) and DLCO (<0.009) following PD. PS 1 patients showed significant improvements in Global Health (p=0.05) functional measures (p< 0.01) and symptoms scores (p <0.03) at 4-5 months and this was maintained at 6-7 months following PD. Improvement also was noted in the FVC (p=0.09), FEV1(p=0.04) and DLCO (p=0.09) in these patients.

    Conclusion
    At intermediate follow-up, extended PD for MPM had a negative impact on pulmonary function in minimally symptomatic patients without any significant improvement in QoL. In contrast, patients who were symptomatic at baseline significantly improved in QoL and showed a modest improvement in pulmonary function after PD. The change in pulmonary function may be partially responsible for the observed QoL in symptomatic patients undergoing PD.

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