Hyperthermic intraoperative pleural cisplatin chemotherapy extends interval to recurrence and survival among low-risk patients with malignant pleural mesothelioma undergoing surgical macroscopic complete resection

Sugarbaker, David J.; Gill, Ritu R.; Yeap, Beow Y.; Wolf, Andrea; DaSilva, Marcelo C.; Baldini, Elizabeth H.; Bueno, Raphael; Richards, William G.

doi:10.1016/j.jtcvs.2012.12.037

Cited by 140 publications

(156 citation statements)

References 25 publications

(32 reference statements)

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“…There are few studies suggesting the superiority of adding HIPEC to cytoreductive surgery in MPM. [20] The results of the present study support the findings of such studies although direct comparison of the same surgical approach with or without HIPEC has not been performed.…”

Section: Discussionsupporting

confidence: 85%

“…Surgical approaches such as EPP and lung sparing pleurectomy plus decortication have been performed to remove tumoral mass in MPM patients. [3][4][5][6][7][8][20][21][22][23][24] Pneumonectomy…”

Section: Discussionmentioning

confidence: 99%

“…[18] Also, some authors approved its potentiating effect on penetration of chemotherapeutic agents. [11][12][13]17,18] Sugarbaker et al [20] published their results on the effect of HIPEC among low-risk patients. They found longer survival time in patients treated with HIPEC (35.3 versus 22.8 months).…”

Section: Discussionmentioning

confidence: 99%

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Can hyperthermic intrathoracic perfusion chemotherapy added to lung sparing surgery be the solution for malignant pleural mesothelioma?

Işık¹

2016

Turk Gogus Kalp Dama

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ÖZAmaç: Bu çalışmada, malign plevral mezotelyomalı hastalarda akciğer koruyucu sitoredüktüf cerrahiye eklenen hipertermik toraks içi perfüzyon kemoterapisinin sağkalım açısından ekstraplevral pnömonektomiye üstün olup olmadığı araştırıldı.Ça lış ma pla nı: Ocak 2002 -Haziran 2014 tarihleri arasında kliniğimizde yatan malign plevral mezotelyomalı 73 hastanın (35 erkek, 38 kadın; ort yaş 55.9±12.3 yıl; dağılım 20-80 yıl) verileri retrospektif olarak incelendi. Hastalar grup 1 (n=20, yalnız ekstraplevral pnömonektomi), grup 2 (n=17, yalnızca palyatif tedavi) ve grup 3 (n=36, akciğer koruyucu sitoredüktif cerrahi artı hipertermik toraks içi perfüzyon kemoterapisi) olmak üzere üç gruba ayrıldı. Tedavi grupları, sağkalım ve hastalıksız süre açısından karşılaştırıldı. Bul gu lar:Medyan sağkalımlar grup 1, 2 ve 3'te sırası ile beş, altı ve 27 ay idi. İki yıllık sağkalım grup 3'te %56.5 iken grup 1'de %15 ve grup 2'de %17.6 idi (p= 0.01). Bununla birlikte, dört yıllık sağkalım oranı grup 3'te (%14.6) grup 1 (%0) ve 2 (%11.8) ile karşılaştırıldığında anlamlı olarak daha yüksekti. Sağkalım zamanı grup 3'te epitelyal ve bifazik histolojiler arasında anlamlı olarak farklı değildi (sırası ile medyan 28 ve 27 ay).So nuç:Bu çalışmanın sonuçları, malign plevral mezotelyomada akciğer koruyucu sitoredüktif cerrahiye eklenen hipertermik toraks içi perfüzyon kemoterapisinin yalnız ekstraplevral pnömonektomi veya palyatif tedaviye göre daha az morbidite ile daha uzun sağkalım sağladığını göstermektedir. Epitelyal olmayan malign plevral mezotelyoma olgularında da akciğer koruyucu sitoredüktif cerrahiye eklenen hipertermik toraks içi perfüzyon kemoterapisinin kullanılmasını önermekteyiz.Anah tarsöz cük ler: Hipertermik perfüzyon kemoterapisi; mezotelyoma; plevra; cerrahi. ABSTRACTBackground: This study aims to investigate whether hyperthermic intrathoracic perfusion chemotherapy added to lung sparing cytoreductive surgery is superior to extrapleural pneumonectomy in patients with malignant pleural mesothelioma in terms of survival.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

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Can hyperthermic intrathoracic perfusion chemotherapy added to lung sparing surgery be the solution for malignant pleural mesothelioma?

Işık¹

2016

Turk Gogus Kalp Dama

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“…In a recent retrospective study, hyperthermic intraoperative chemotherapy with cisplatin was found to yield a shorter time interval to recurrence and increased overall survival [65].…”

Section: Further Developmentsmentioning

confidence: 98%

Multimodal management of malignant pleural mesothelioma: where are we today?

Schil

Opitz²,

Weder³

et al. 2014

European Respiratory Journal

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The prognosis of patients with malignant pleural mesothelioma remains poor and although it is clear that multimodal therapy is necessary to improve long-term results, precise treatment schemes have not yet been unequivocally established. Single-modality therapy does not have a major impact on long-term survival and combined-modality therapies are being further evaluated. However, the relative contributions of chemotherapy, radiotherapy and surgery have not been clearly determined at the present time. Moreover, the extent of resection and precise surgical procedure remain a highly debated topic. To better compare and combine results from different institutions and trials, uniform definitions of surgical procedures including extrapleural pneumonectomy and different forms of pleurectomy have recently been introduced. Due to the relatively higher morbidity and mortality of extrapleural pneumonectomy, there is currently a shift towards pleurectomy/decortication when a macroscopic complete resection of all tumour can be obtained by this procedure. In most recent trials, induction chemotherapy was administered to improve surgical resection rates but pathological complete responses are infrequently observed. The role of post-operative radiotherapy has to be further elucidated.Further treatment options that are currently explored include hyperthermic intrapleural chemotherapy, immunotherapy, gene therapy and photodynamic therapy. However, no randomised comparisons are available yet. @ERSpublications Treatment of malignant pleural mesothelioma remains controversial

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“…EPP, in fact, seemed to be the best operation to allow postoperative hemithoracic radiation to treat residual microscopic disease, without concerns for possible pulmonary toxicity. Moreover, the recent development of intrapleural hyperthermic cisplatin-based CT, led selected specialist Centres to improve survival by reducing the risk of locoregional tumor relapses (16,17).…”

Section: Eppmentioning

confidence: 99%

Pleurectomy/decortication versus extrapleural pneumonectomy: a critical choice

et al. 2018

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Hyperthermic intraoperative pleural cisplatin chemotherapy extends interval to recurrence and survival among low-risk patients with malignant pleural mesothelioma undergoing surgical macroscopic complete resection

Abstract: A favorable outcome and minimal incremental morbidity support the incorporation of hyperthermic intraoperative cisplatin chemotherapy into multimodality treatment strategies for patients with low-risk epithelial malignant pleural mesothelioma.

Cited by 140 publications

References 25 publications

Can hyperthermic intrathoracic perfusion chemotherapy added to lung sparing surgery be the solution for malignant pleural mesothelioma?

Can hyperthermic intrathoracic perfusion chemotherapy added to lung sparing surgery be the solution for malignant pleural mesothelioma?

Multimodal management of malignant pleural mesothelioma: where are we today?

Pleurectomy/decortication versus extrapleural pneumonectomy: a critical choice

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