Malignant pleural mesothelioma

Abstract

Background: malignant pleural mesothelioma is an aggressive tumor with uncommon incidence and difficult diagnosis. The treatment of this pathology is disappointing, with bad response to chemoradiotherapy only. According to recent publications, multimodal treatment should be the best modality to improve prognosis.
Objetives: to analyze our experience with combined treatment modalities in early stage patients.
Material and methods: we analyzed 22 patients, 18 with epithelial, 3 sarcomatoide, and 1 biphasic subtype. On the basis of cardiopulmonary reserve, nutritional status and TNM staging, we divided our patients in three groups according to the therapeutic modality: Group 1: extrapleural pleuropneumonectomy (n = 6); group 2: pleurectomy/decortication(n = 7); group 3: pleural sinphisis (n = 9).
Results: Group 1: one bronchial fistula and tracheoesophageal fistula was reported with no operative mortality. Median survival was 22 months. Group 2: recidivant pleural effusion and residual pleural cavity with a patient who died due to arrhythmia. Median survival was 11.8 months. Group 3: two patients with recidivant pleural effusion. No operative mortality. Survival: 5 months.
Conclusions: in our experience, the best survival was observed using multimodal treatment, including surgery and chemoradiotherapy.