WCLC 2025 - Posters & ePosters-EP.14.05 Predictive Factors of Postoperative Long-Term Survival in Patient With Pleural Mesothelioma

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This retrospective study analyzed predictive factors for long-term survival in 255 patients with pleural mesothelioma (PM) undergoing curative-intent surgery at two high-volume centers in Japan between 2006 and 2019. Long-term survival was defined as overall survival (OS) of 5 years or more, achieved by 30.2% (77 patients), with a median survival time of 37.4 months.<br /><br />Key characteristics of long-term survivors included a median age of 63 years, a predominance of males (83.1%), and mainly epithelioid histology (97.4%). Most had clinical tumor stage c-T1 based on the 9th edition TNM classification (67.5%) and underwent pleurectomy/decortication (P/D) surgery (74%). Severe postoperative complications were relatively rare among survivors (6.5%).<br /><br />Univariate and multivariate analyses identified several significant predictive factors for 5-year survival. Younger age (<70 years) was associated with better survival (odds ratio [OR] 3.76, p=0.01). The updated c-T factor (version 9), specifically c-T1 stage, strongly predicted long-term survival (OR 4.67, p=0.001). Absence of severe postoperative complications greatly increased survival odds (OR 6.34, p=0.001). Lower intraoperative blood loss also correlated with better outcomes (OR 1.97, p=0.04). Other factors such as sex, performance status, histological subtype besides epithelioid, and type of surgery (P/D vs. extrapleural pneumonectomy) were not independently predictive.<br /><br />The study suggests that optimal patient selection focusing on those with early-stage disease (c-T1 ver.9), alongside meticulous perioperative care to minimize severe complications, is critical to achieving long-term survival after surgery in pleural mesothelioma. This evidence supports refined staging and surgical management strategies to improve prognosis in this challenging malignancy.

Asset Subtitle

Masaki Hashimoto

Meta Tag

Speaker Masaki Hashimoto

Topic Mesothelioma, Thymoma, and Other Thoracic Tumors

Keywords

pleural mesothelioma

long-term survival

curative-intent surgery

epithelioid histology

c-T1 tumor stage

pleurectomy/decortication

postoperative complications

intraoperative blood loss

predictive factors

patient selection