P Bertoglio1, M C Ambrogi2, A Chella3, V Aprile2, P Dini4, S Korasidis2, O Fanucchi4, A Mussi2. 1. Division of Thoracic Surgery, Department of Surgical, Medical, Molecular, and Critical Area Pathology, University Hospital of Pisa, via Paradisa 2, 56100 Pisa, PI, Italy. Electronic address: pieberto@hotmail.com. 2. Division of Thoracic Surgery, Department of Surgical, Medical, Molecular, and Critical Area Pathology, University Hospital of Pisa, via Paradisa 2, 56100 Pisa, PI, Italy. 3. Division of Pneumology, Cardio Thoracic and Vascular Department, University Hospital of Pisa, via Paradisa 2, 56100 Pisa, PI, Italy. 4. Division of Thoracic Surgery, Cardio Thoracic and Vascular Department, University Hospital of Pisa, via Paradisa 2, 56100 Pisa, PI, Italy.
Abstract
OBJECTIVES: No clear evidence of which surgical procedure should be performed for early stage mesothelioma is available to date. We analyzed our 10-year experience in the treatment of early stage mesothelioma with surgery and Hyperthermic IntraTHOracic Chemotherapy. METHODS: We retrospectively analyzed all cases of histologically proven epithelioid or biphasic IMIG stage I and II mesothelioma that we operated between 2005 and 2014. We performed an open pleurectomy and partial decortication of any visible lesion on the visceral pleura in all cases and both diaphragm and pericardium were always spared; Hyperthermic IntraTHOracic Chemotherapy was ran using Cisplatin 80 mg/m2 and Doxorubicin 25 mg/m2 at a target temperature of 42.5 °C for 60 min. RESULTS: We operated on 26 patients (23 male and 3 female); epithelioid tumor was diagnosed in 23 cases. Twelve patients were in IMIG stage I and 14 in IMIG stage II; median overall survival for all patients, stage I and II were 35.6, 46 and 23 months respectively and disease free survival was 18, 18 and 16 months respectively. Our results for stage I were better than those reported in literature and were similar for stage II. We observe no 30- and 90- mortality and the rate of severe complication (all CTCAE stage 3) were 30%; the median postoperative stay was 7.5 days. CONCLUSIONS: Our lung sparing approach for the treatment of pleural mesothelioma in early stages allows promising long term outcomes with a complete sparing of pulmonary and diaphragmatic function. Larger studies are needed to confirm our good results.
OBJECTIVES: No clear evidence of which surgical procedure should be performed for early stage mesothelioma is available to date. We analyzed our 10-year experience in the treatment of early stage mesothelioma with surgery and Hyperthermic IntraTHOracic Chemotherapy. METHODS: We retrospectively analyzed all cases of histologically proven epithelioid or biphasic IMIG stage I and II mesothelioma that we operated between 2005 and 2014. We performed an open pleurectomy and partial decortication of any visible lesion on the visceral pleura in all cases and both diaphragm and pericardium were always spared; Hyperthermic IntraTHOracic Chemotherapy was ran using Cisplatin 80 mg/m2 and Doxorubicin 25 mg/m2 at a target temperature of 42.5 °C for 60 min. RESULTS: We operated on 26 patients (23 male and 3 female); epithelioid tumor was diagnosed in 23 cases. Twelve patients were in IMIG stage I and 14 in IMIG stage II; median overall survival for all patients, stage I and II were 35.6, 46 and 23 months respectively and disease free survival was 18, 18 and 16 months respectively. Our results for stage I were better than those reported in literature and were similar for stage II. We observe no 30- and 90- mortality and the rate of severe complication (all CTCAE stage 3) were 30%; the median postoperative stay was 7.5 days. CONCLUSIONS: Our lung sparing approach for the treatment of pleural mesothelioma in early stages allows promising long term outcomes with a complete sparing of pulmonary and diaphragmatic function. Larger studies are needed to confirm our good results.
Authors: Swaantje Casjens; Daniel G Weber; Georg Johnen; Irina Raiko; Dirk Taeger; Carmen Meinig; Susanne Moebus; Karl-Heinz Jöckel; Thomas Brüning; Beate Pesch Journal: BMJ Open Date: 2017-10-11 Impact factor: 2.692
Authors: Till Markowiak; Michael Koller; Florian Zeman; Gunnar Huppertz; Hans-Stefan Hofmann; Michael Ried Journal: BMJ Open Date: 2020-07-20 Impact factor: 2.692