Author of

• 16935

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  P1.08 - Poster Session with Presenters Present (ID 460)

  • Event: WCLC 2016
  • Type: Poster Presenters Present
  • Track: Surgery
  • Presentations: 1
  • Moderators:
  • Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)

  • 17018

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    P1.08-083 - Hyperthermic Pleural Lavage for Pleural Metastases (ID 5343)

    14:30 - 14:30  |  Author(s): J.D. Whetstone
    • Abstract

    Background:
    To evaluate the safety and efficacy of hyperthermic pleural lavage (HTPL) with cisplatin in patients who have undergone cytoreductive surgery pleurectomy/decortication (PD) for isolated chemoresistant pleural metastases (PM). This may be an alternative treatment for patients with isolated pleural metastases with controlled primary disease.
    
    Methods:
    After Health Care System and Cancer Committee approval, 10 patients with unilateral chemo resistant pleural metastasis were registered prospectively. The patients’’ primary sites of malignancy were under control for a median of 40 months (range, 28-76). Patients underwent a unilateral radical P/D and lymph node dissection, 60 minute pleural lavage (1,500 – 1,700 cc/min) with 225 mg/m2 of cisplatin at 42°C. Cisplatin levels were drawn at time zero, 1 hour, 4 hours, and 24 hours after completion of HTPL.
    
    Results:
    Median age was 53 years (range, 38-64); 7 patients (70%) were women. Primary tumor: breast 5, colon 2, and thymic, renal cell and anal cancer 1 each. Surgical approach was a thoracotomy in 9 patients (90%). Morbidity included atrial fibrillation in 3 (30%), and acute respiratory distress syndrome in 1 (10%). Median hospital stay 7 days (range, 4-14). Serum cisplatin levels peaked at 4 hours after lavage; none to toxic range. Median dose of cisplatin was 386 mg (range, 299-450); no patient developed renal insufficiency. Median follow up was 10 months (range, 1-15). 8 patients had no signs of malignant disease at last follow up; 1 patient (anal cancer – 6 months) developed local recurrence and 1 patient (renal cell cancer – 9 months) developed contralateral pleural disease. All patients experienced improved quality of life, respiratory function, and reduced pleuritic pain.
    
    Conclusion:
    Surgical cytoreduction of chemoresistant PM followed by HTPL with cisplatin was well tolerated with no cisplatin-related toxicities. Early results are promising. This novel treatment for patients with isolated secondary PM represents the first series reported. Longer follow-up is warranted to determine a survival and quality of life advantage as well as defined inclusion and exclusion criteria.