Akifumi Nakamura1, Teruhisa Takuwa2, Masaki Hashimoto2, Ayumi Kuroda2, Toru Nakamichi2, Seiji Matsumoto2, Nobuyuki Kondo2, Takashi Kijima3, Koichiro Yamakado4, Seiki Hasegawa2. 1. Division of Thoracic Surgery, Department of Surgery, Hyogo College of Medicine, Hyogo, Japan. Electronic address: xxmp97511@zeus.eonet.ne.jp. 2. Division of Thoracic Surgery, Department of Surgery, Hyogo College of Medicine, Hyogo, Japan. 3. Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan. 4. Department of Radiology, Hyogo College of Medicine, Hyogo, Japan.
Abstract
BACKGROUND: Most patients with malignant pleural mesothelioma experience recurrence after treatment. However no clinical studies have evaluated postrecurrence survival after pleurectomy/decortication for malignant pleural mesothelioma. This study aimed to clarify postrecurrence survival, treatment, prognostic factors, and recurrence pattern after pleurectomy/decortication. METHODS: We conducted a retrospective cohort study of 90 patients who underwent neoadjuvant chemotherapy followed by pleurectomy/decortication at our hospital between September 2012 and December 2017. Survival and recurrence were calculated using the Kaplan-Meier method with the log-rank test. Clinical factors related to postrecurrence survival were assessed using multivariate analysis with the Cox proportional hazards model. RESULTS: Of 90 patients, 57 (63.3%) developed recurrence. The 1- and 3-year recurrence-free survival rates were 69.7% and 34.0%, respectively (median recurrence-free survival time, 19.0 months). With regard to initial recurrence, 39 patients (68.4%) developed local recurrence, 6 (10.5%) developed distant recurrence, and 12 (21.1%) developed both local and distant recurrences. The 1-year postrecurrence survival rate was 59.5% (median post-recurrence survival time, 14.4 months). Forty-three patients (75.4%) underwent a postrecurrence treatment. Multivariate analysis revealed that postrecurrence treatment (hazard ratio, 0.2; 95% confidence interval, 0.07-0.55; P = .002), performance status 0 to 1 (hazard ratio, 0.24; 95% confidence interval, 0.08-0.76; P = .01), and disease-free interval more than 12 months (hazard ratio, 0.4; 95% confidence interval, 0.16-0.99; P = .04) were the independent, favorable, and significant prognostic factors of postrecurrence survival. CONCLUSIONS: Postrecurrence survival after pleurectomy/decortication is acceptable, and postrecurrence treatment, performance status, and disease-free interval are important prognostic factors of postrecurrence survival.
BACKGROUND: Most patients with malignant pleural mesothelioma experience recurrence after treatment. However no clinical studies have evaluated postrecurrence survival after pleurectomy/decortication for malignant pleural mesothelioma. This study aimed to clarify postrecurrence survival, treatment, prognostic factors, and recurrence pattern after pleurectomy/decortication. METHODS: We conducted a retrospective cohort study of 90 patients who underwent neoadjuvant chemotherapy followed by pleurectomy/decortication at our hospital between September 2012 and December 2017. Survival and recurrence were calculated using the Kaplan-Meier method with the log-rank test. Clinical factors related to postrecurrence survival were assessed using multivariate analysis with the Cox proportional hazards model. RESULTS: Of 90 patients, 57 (63.3%) developed recurrence. The 1- and 3-year recurrence-free survival rates were 69.7% and 34.0%, respectively (median recurrence-free survival time, 19.0 months). With regard to initial recurrence, 39 patients (68.4%) developed local recurrence, 6 (10.5%) developed distant recurrence, and 12 (21.1%) developed both local and distant recurrences. The 1-year postrecurrence survival rate was 59.5% (median post-recurrence survival time, 14.4 months). Forty-three patients (75.4%) underwent a postrecurrence treatment. Multivariate analysis revealed that postrecurrence treatment (hazard ratio, 0.2; 95% confidence interval, 0.07-0.55; P = .002), performance status 0 to 1 (hazard ratio, 0.24; 95% confidence interval, 0.08-0.76; P = .01), and disease-free interval more than 12 months (hazard ratio, 0.4; 95% confidence interval, 0.16-0.99; P = .04) were the independent, favorable, and significant prognostic factors of postrecurrence survival. CONCLUSIONS: Postrecurrence survival after pleurectomy/decortication is acceptable, and postrecurrence treatment, performance status, and disease-free interval are important prognostic factors of postrecurrence survival.
Authors: Cristiano Breda; Simone Furia; Giuseppe Lucchini; Antonio Zaccaria; Enrico Verderi; Giuseppe Natale; Fabio Lo Giudice; Roberta Cavallin; Andrea Ferronato; Paolo Fontana Journal: J Thorac Dis Date: 2021-11 Impact factor: 2.895
Authors: Giuseppe Mangiameli; Edoardo Bottoni; Umberto Cariboni; Giorgio Maria Ferraroli; Emanuela Morenghi; Veronica Maria Giudici; Emanuele Voulaz; Marco Alloisio; Alberto Testori Journal: J Clin Med Date: 2022-08-03 Impact factor: 4.964
Authors: Alice Bellini; Andrea Dell'Amore; Stefano Terzi; Giovanni Zambello; Andrea Zuin; Giulia Pasello; Fiorella Calabrese; Marco Schiavon; Federico Rea Journal: J Clin Med Date: 2021-03-08 Impact factor: 4.241