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J. Kim



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    P3.09 - Mesothelioma (ID 725)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Mesothelioma
    • Presentations: 1
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      P3.09-008 - Role of Surgery in the Multimodality Treatment of Malignant Pleural Mesothelioma (ID 9827)

      09:30 - 09:30  |  Author(s): J. Kim

      • Abstract

      Background:
      The treatment of malignant pleural mesothelioma is challenging and multimodality treatment including surgery is recommended, although there are debates about the role of surgery. We analyzed the outcomes of surgery in MPM in the context of multimodality treatment focusing on extrapleural pneumonectomy (EPP).

      Method:
      Total 29 patients had pathologically proven malignant pleural mesothelioma from April 1998 to July 2015 were retrospectively reviewed. The overall survival rates of surgery group (any type of curative surgical treatment) and medical group (medical treatment only) were compared. Prognoses of EPP subgroup and medical group were also compared

      Result:
      Among 29 patients, 16 patients underwent surgery for curative intent, 12 patients underwent definitive chemotherapy, and one patient refused treatment. Epithelioid type (n=11, 68.8%) was the most common pathologic type in surgery group. Only 4 (33.3%) patients of medical group were epithelioid type. Half of surgery group patients were clinical stage I/II and there was no clinical stage I/II in medical group. Pulmonary functions of both group were not significantly different. In surgery group, 11 patients underwent EPP and one patient underwent pleurectomy/decortication. Four patients misdiagnosed as lung cancer preoperatively underwent lobectomy with chest wall resection. There were no postoperative 30-day nor in-hospital mortality. The median follow-up duration was 10.6 (1.0-78) months. The median survival time (MST) was 10.6 months, and the 3-year overall survival rate (3yr-OS) was 25 %. There was no statistical difference in overall survival between surgery and medical group (MST = 10.6 vs. 8.4 months, 3yr-OS = 31.1 % vs 16.7%, p=0.47) EPP subgroup (MST = 13.3 months, 3yr-OS = 45.5 %) also showed statistically similar survival with medical group (p=0.23). (Fig 1)Figure 1



      Conclusion:
      Multimodality treatment incorporating surgery was not superior compared with medical treatment in MPM. EPP with multimodality treatment also failed to show meaningful superior prognosis compared with non-surgical treatment in MPM.