Non-incisional pleurectomy/decortication for malignant pleural mesothelioma

Tanaka, Fumihiro; Takenaka, Masaru; Imanishi, Naoko; Hirai, Ayako; Kanayama, Masatoshi; Mori, Masataka; Matsumiya, Hiroki; Taira, Akihiro; Shinohara, Shinji; Kuroda, Koji

doi:10.1007/s11748-021-01643-z

Cited by 3 publications

(1 citation statement)

References 21 publications

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“…The other 54 patients received P/D for initially resectable MPM (non-salvage P/D) (Table 1 ). Non-incisional P/D technique was employed to achieve en bloc resection of the entire pleura [ 8 ]. The resected diaphragm and pericardium were reconstructed, when extended P/D was performed to achieve MCR.…”

Section: Resultsmentioning

confidence: 99%

Salvage pleurectomy/decortication following immunotherapy for malignant pleural mesothelioma

Takenaka,

Kuroda,

Yoshimatsu

et al. 2023

Interdisciplinary CardioVascular and Thoracic Surgery

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Salvage surgery following immunotherapy is a promising treatment option for advanced malignant tumour. However, only a few cases of salvage surgery for malignant pleural mesothelioma (MPM) have been reported. This retrospective study was conducted to assess the feasibility of salvage surgery following immunotherapy for initially unresectabele MPM. Among 61 patients who received pleurectomy/decortication (P/D) for MPM, 7 patients received salvage P/D after immunotherapy. Surgical indication of salvage P/D was conversion to resectability in 5 patients and local relapse in 2 patients, and macroscopic complete resection was achieved in all patients. Although salvage P/D was associated with longer operation time (median, 507 min), higher intraoperative blood loss (median, 2573 mL) and higher morbidity (≥ Grade 3, 29%), no patient died after surgery. Radiographic response to immunotherapy was well correlated with pathologic response, as all 4 patients with partial response showed significant pathologic response (viable cells, ≤ 50%). With the median postoperative follow-up duration of 9.0 months, all patients were alive mostly without tumour recurrence as local recurrence developed in one patient. To conclude, salvage P/D after immunotherapy may be a feasible treatment option for selected patients with advanced MPM, which should be validated in future multi-institutional studies. In addition, a long-term follow-up is essential to reveal clinical benefit achieved with salvage P/D following immunotherapy.

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Section: Resultsmentioning

confidence: 99%