Korean J Thorac Cardiovasc Surg.  2018 Feb;51(1):35-40. 10.5090/kjtcs.2018.51.1.35.

Outcomes of the Multimodal Treatment of Malignant Pleural Mesiothelioma: The Role of Surgery

• Na BS
• Kim JS
• Hyun K
• Park IK
• Kang CH
• Kim YT

• KMID: 2409711
• DOI: http://doi.org/10.5090/kjtcs.2018.51.1.35

Abstract

BACKGROUND
The treatment of malignant pleural mesothelioma (MPM) is challenging, and multimodal treatment including surgery is recommended; however, the role of surgery is debated. The treatment outcomes of MPM in Korea have not been reported. We analyzed the outcomes of MPM in the context of multimodal treatment, including surgery.
METHODS
The records of 29 patients with pathologically proven MPM from April 1998 to July 2015 were retrospectively reviewed. The treatment outcomes of the surgery and non-surgery groups were compared.
RESULTS
The overall median survival time was 10.6 months, and the overall 3-year survival rate was 25%. No postoperative 30-day or in-hospital mortality occurred in the surgery group. Postoperative complications included tachyarrhythmia (n=4), pulmonary thromboembolism (n=1), pneumonia (n=1), chylothorax (n=1), and wound complications (n=3). The treatment outcomes between the surgery and non-surgery groups were not significantly different (3-year survival rate: 31.3% vs. 16.7%, respectively; p=0.47). In a subgroup analysis, there was no significant difference in the treatment outcomes between the extrapleural pneumonectomy group and the non-surgery group (3-year survival rate: 45.5% vs. 16.7%, respectively; p=0.23).
CONCLUSION
Multimodal treatment incorporating surgery did not show better outcomes than non-surgical treatment. A nationwide multicenter data registry and prospective randomized controlled studies are necessary to optimize the treatment of MPM.

Keyword

Mesothelioma; Surgery; Prognosis

MeSH Terms

Chylothorax
Combined Modality Therapy*
Hospital Mortality
Humans
Korea
Mesothelioma
Pneumonectomy
Pneumonia
Postoperative Complications
Prognosis
Prospective Studies
Pulmonary Embolism
Retrospective Studies
Survival Rate
Tachycardia
Wounds and Injuries