2023 World Conference on Lung Cancer (Posters)-EP14.01. Multimodal Treatment in Malignant Pleural Mesothelioma: An Institutional Experience of 432 Patients over a 29 Year Period

EP14.01. Multimodal Treatment in Malignant Pleural Mesothelioma: An Institutional Experience of 432 Patients over a 29 Year Period - PDF(Abstract)

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This study presents the results of a large institutional experience with the multimodal treatment of malignant pleural mesothelioma (MPM) over a 29-year period. The researchers analyzed data from 432 patients diagnosed with MPM between 1994 and 2023 at the Medical University of Vienna. The impact of different treatment modalities on overall survival (OS), disease-free survival (DFS), and treatment-related morbidity was evaluated.<br /><br />The median overall survival for the entire cohort was 16.3 months. Multimodality treatment protocols were used in 48.2% of patients, while 41.2% received single modalities and 10.6% received best supportive care. The OS for these groups was 23.2, 10.7, and 6.6 months, respectively. Patients who underwent trimodality therapy, consisting of induction chemotherapy, extrapleural pneumonectomy (EPP), and adjuvant pleural intensity-modulated radiotherapy, had a significantly longer OS of 24.1 months and a 5-year survival rate of 29%.<br /><br />A sub-group of patients received neoadjuvant or adjuvant IMRT (intensity-modulated radiotherapy) followed by EPP, with no significant difference in survival between the two groups. Radical surgery, either EPP or extended pleurectomy and decortication (EPD), was performed on 33.8% of patients. EPD was associated with a significantly better DFS compared to EPP.<br /><br />In terms of prognostic factors, surgical treatment, multimodality therapy, epithelioid subtype, early tumor stage, age, and sex were found to be significant predictors of OS. In multivariate analysis, the epithelioid subtype, multimodality treatment, and early stage were independently associated with a survival benefit.<br /><br />Overall, the study concludes that multimodality treatment protocols and radical surgery significantly prolonged OS in MPM patients compared to single therapies without surgery. This highlights the importance of a multidisciplinary approach in the management of MPM and provides insights into treatment strategies for this aggressive thoracic malignancy.<br /><br />Keywords: Mesothelioma, Multimodality, Malignant Pleural Mesothelioma, Thoracic Tumors.

Asset Subtitle

Mir Alireza Hoda

Meta Tag

Speaker Mir Alireza Hoda

Topic Mesothelioma, Thymoma & Other Thoracic Tumors

Keywords

Mesothelioma

Multimodality

Malignant Pleural Mesothelioma

Thoracic Tumors

Overall Survival

Disease-Free Survival

Treatment-related Morbidity

Trimodality Therapy

Extrapleural Pneumonectomy

Adjuvant Pleural Intensity-modulated Radiotherapy