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(Slides)

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This study analyzed the outcomes of 432 patients with malignant pleural mesothelioma (MPM) over a 29-year period. MPM is a highly aggressive and deadly cancer caused by asbestos exposure. The study aimed to determine the effectiveness of different treatment modalities in improving overall survival (OS) and disease-free survival (DFS) in MPM patients.<br /><br />The patients included in the study had a median age of 67 and were predominantly male. The median OS for the entire cohort was 16.3 months. The researchers found that multimodality treatment protocols had better outcomes compared to single modalities or best supportive care. Specifically, patients who received trimodality therapy, which included induction chemotherapy, extrapleural pneumonectomy (EPP), and adjuvant pleural intensity modulated radiotherapy (IMRT), had a significantly longer OS of 24.1 months and a 5-year survival rate of 29%.<br /><br />A small subgroup of patients received neoadjuvant IMRT with or without chemotherapy followed by EPP. There was no significant difference in survival between the neoadjuvant and adjuvant IMRT groups. Radical surgery, either EPP or lung-sparing extended pleurectomy and decortication (EPD), was performed in 146 patients. EPD had a significantly better DFS (28.2 months) compared to EPP (17.3 months).<br /><br />Several factors were identified as prognostic factors for OS, including surgical treatment, multimodality therapy, epithelioid subtype, early tumor stage, age, and sex. In multivariate analysis, epithelioid subtype, multimodality treatment, and early stage were independently associated with a survival benefit.<br /><br />In conclusion, multimodality treatment protocols, particularly those including radical surgery, significantly improved OS in MPM patients compared to single therapies without surgery. These findings suggest that a multidisciplinary approach combining systemic therapy, radiation, and surgery can lead to better outcomes for MPM patients.

Asset Subtitle

Mir Alireza Hoda

Meta Tag

Speaker Mir Alireza Hoda

Topic Mesothelioma, Thymoma & Other Thoracic Tumors

Keywords

malignant pleural mesothelioma

asbestos exposure

treatment modalities

overall survival

disease-free survival

trimodality therapy

neoadjuvant IMRT

radical surgery

prognostic factors

multidisciplinary approach