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H. Hofmann
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P2.08 - Poster Session/ Thymoma, Mesothelioma and Other Thoracic Malignancies (ID 225)
- Event: WCLC 2015
- Type: Poster
- Track: Thymoma, Mesothelioma and Other Thoracic Malignancies
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.08-011 - Surgical Cytoreduction and HITHOC for Malignant Pleural Tumors (ID 375)
09:30 - 09:30 | Author(s): H. Hofmann
- Abstract
Background:
Combination of surgical cytoreduction and hyperthermic intrathoracic chemotherapy (HITHOC) is performed for therapy of pleural malignancies within a multimodality treatment concept. We describe the perioperative management and our clinical experience.
Methods:
Between September 2008 and January 2015 a total of 23 patients with malignant pleural mesothelioma (MPM) and 27 patients with thymoma/thymic carcinoma with pleural involvement (Masaoka-stage IVa) were prospectively enrolled. Perioperative management, postoperative morbidity and mortality were analyzed.
Results:
Included were 17 female and 33 male patients with a mean age of 54.6 years (25 to 72 years). All patients received multimodality therapy depending on tumor stage, histology and their overall condition. Histologic subtype of patients with MPM was epitheloid (n= 19; 83%) or biphasic (n= 4; 17%). WHO-classification of thymoma patients was: B1 n= 2, B2 n= 10, B2/B3 n= 6, B3 n= 4 and C n= 5. All patients underwent radical surgical cytoreduction with pleurectomy/decortication (P/D; n= 25), extended P/D (P/D + resection of pericardium and/or diaphragm; n= 19) or extrapleural pleuro-pneumonectomy (EPP; n= 6) followed by HITHOC perfusion at 42°C for one hour. HITHOC was performed with an increasing concentration of cisplatin (100 mg/m[2] n= 14; 150 mg/m[2] n= 18; 175 mg/m[2] n= 2) or combination of cisplatin/doxorubicin (175 mg/m[2 ]/ 65 mg n= 16). Macroscopic complete resection (R0/R1) was achieved in 46 patients (92%). Severe chemotherapy-related complications were not observed. Operative revision was necessary in seven patients (14%). Postoperative renal insufficiency was observed in six patients (12%) with two patients requiring temporary postoperative dialysis (4%). Prolonged bronchopleural fistula was documented in five patients (11%) after lungsparing P/D or extended P/D. 30-day mortality was 4%, both after EPP.
Conclusion:
Surgical cytoreduction in combination with HITHOC can be performed with acceptable morbidity and mortality rates in selected patients. Patients should be evaluated interdisciplinary to determine their eligibility for this multimodality approach. Early clinical results may encourage the use of additional HITHOC to provide better local tumor control.
